Individual
MR. JOSE JESUS SANTIAGO-ROQUE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350
Mailing address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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