Individual
MR. EUGENE VRUCE MENESES FERNANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4920 N. CENTRAL AVENUE, CHICAGO, IL 60630-2028
(773) 205-8911
Mailing address
5642 N MAJOR AVE, CHICAGO, IL 60646-6417
(773) 603-8648
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017638
IL
Other
Enumeration date
04/16/2010
Last updated
04/16/2010
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