Individual
MR. DANIEL JASON ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1330 E COOLEY DR, COLTON, CA 92324-3905
(909) 423-0750
Mailing address
950 N DUESENBERG DR APT 1314, ONTARIO, CA 91764-5961
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95173057
CA
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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