Individual
ROY GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
40 RIDGEVIEW RD, SIOUX CITY, IA 51104-4052
(712) 204-4297
Mailing address
40 RIDGEVIEW RD, SIOUX CITY, IA 51104-4052
(712) 204-4297
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
1463
NE
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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