Individual
MR. ALFREDO ENRIQUEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
3401 SOLDIERS HOME RD, WEST LAFAYETTE BRA, IN 47906-1222
(765) 463-1541
Mailing address
3576 CAVENDISH CT, WEST LAFAYETTE BRA, IN 47906-0813
(765) 743-2253
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
31004248A
IN
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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