Individual
MR. JUAN CARLOS REBOLLO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
38 PROSPECT ST., APARTMENT A6, NAUGATUCK, CT 06770-3045
(860) 218-7027
Mailing address
38 PROSPECT STREET, APARTMENT A6, NAUGATUCK, CT 06770-3045
(860) 218-7027
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
NA9988812
CT
376K00000X
Nurse's Aide
Primary
NA9988812
CT
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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