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1588329494
RICHARD A BOLISENGA
MIDLOTHIAN, IL
NPI
1588329494
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183700000X Pharmacy Technician
(Licence: IL 049.241981)
Enumeration Date
2021-11-04
Last Update Date
2021-11-04
Business Address
RICHARD A BOLISENGA
3812 148TH ST
MIDLOTHIAN, IL 60445-3415
Phone number: 312-415-0058
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Mailing Address
RICHARD A BOLISENGA
3812 148TH ST
MIDLOTHIAN, IL 60445-3415
Phone number: 312-415-0058
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