Individual
LUIS TAFOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4329 MAJESTY CT, ROCKFORD, IL 61109-2507
(815) 721-3797
Mailing address
4329 MAJESTY CT, ROCKFORD, IL 61109-2507
(815) 721-3797
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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