Individual
JORGE LUIS VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(877) 787-3422
Mailing address
15 MAIN ST APT 4, WILLIMANTIC, CT 06226-2955
(860) 617-8754
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002132
CT
Other
Enumeration date
12/17/2021
Last updated
12/17/2021
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