Individual
JAVIER RAMIRO RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
205 N STATE ST, MARENGO, IL 60152-2239
(815) 568-6508
Mailing address
1591 CARLEMONT DR APT B, CRYSTAL LAKE, IL 60014-2742
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011137
IL
Other
Enumeration date
07/21/2017
Last updated
03/17/2018
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