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Individual

ISRAEL RONALDO MENDOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA

Contact information

Practice address
8555 TAFT ST, MERRILLVILLE, IN 46410-6123
(219) 769-4005
Mailing address
4014 RAILROAD AVE, EAST CHICAGO, IN 46312-2548

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/06/2007
Last updated
07/08/2007
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