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1992408215
JOHAN W SOSA DE LA CRUZ
PEORIA, IL
NPI
1992408215
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: IL 125.082150)
Enumeration Date
2023-03-24
Last Update Date
2024-11-22
Business Address
JOHAN W SOSA DE LA CRUZ MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2702
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Mailing Address
JOHAN W SOSA DE LA CRUZ MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number:
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