Individual
MARIO J RICO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 284-2400
Mailing address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 284-2400
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704238708
MI
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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