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1184809048
RODOLFO PINEDA MANANSALA
GREAT LAKES, IL
NPI
1184809048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
(Licence: CA 1710I1002X)
Enumeration Date
2008-01-09
Last Update Date
2009-08-27
Business Address
MR. RODOLFO PINEDA MANANSALA INDEPENDENT DUTY HM
601 D ST BLDG 130-H
GREAT LAKES, IL 60088-2822
Phone number: 847-688-3412
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Mailing Address
MR. RODOLFO PINEDA MANANSALA INDEPENDENT DUTY HM
950 ELFERING LN
ANTIOCH, IL 60002-6404
Phone number: 847-688-3412
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