Individual
MR. LEONID RONQUILLO NEMENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1725 N 5TH ST, TERRE HAUTE, IN 47804-4010
(812) 242-3005
Mailing address
1725 N 5TH ST, TERRE HAUTE, IN 47804-4010
(812) 242-3005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004116A
IN
Other
Enumeration date
12/04/2023
Last updated
12/14/2023
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