Individual
MR. JOSEPH JOSEPH DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1402 BOCA LAGO DR, VALPARAISO, IN 46383-4420
(219) 669-8964
Mailing address
1402 BOCA LAGO DR, VALPARAISO, IN 46383-4420
(219) 669-8964
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
041329061
IL
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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