Individual
ISIDRO ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2460 W 26TH AVE STE 217, DENVER, CO 80211-5308
(303) 322-7108
Mailing address
5620 E 68TH AVE, COMMERCE CITY, CO 80022-2524
(720) 404-4911
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
333121
CO
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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