Individual
MR. JOSE RIOS BLAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
444 W HARRISON AVE, DECATUR, IL 62526-4157
(217) 877-7333
Mailing address
419 E HIGH ST, MONTICELLO, IL 61856-1457
(217) 762-3397
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001368
IL
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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