CARLOS RODOLFO BOCANEGRA CORDOVA

CHAMPAIGN, IL
NPI1376166264
Other NameCARLOS R BOCANEGRA
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085.007669)
Enumeration Date2020-05-26
Last Update Date2020-06-17
Business Address
CARLOS RODOLFO BOCANEGRA CORDOVA PA-C
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820-2101
Phone number: 217-356-1558
Mailing Address
CARLOS RODOLFO BOCANEGRA CORDOVA PA-C
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820-2101
Phone number: 217-356-1558
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