Individual
JOSE ROYECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2106 W WILSHIRE DR, TERRE HAUTE, IN 47802-8305
(812) 878-0901
Mailing address
2106 W WILSHIRE DR, TERRE HAUTE, IN 47802-8305
(812) 878-0901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001216A
IN
Other
Enumeration date
07/18/2016
Last updated
07/19/2016
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