JOHAN W SOSA DE LA CRUZ

PEORIA, IL
NPI1992408215
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  90200000X)
Enumeration Date2023-03-24
Last Update Date2023-03-24
Business Address
JOHAN W SOSA DE LA CRUZ MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2702
Mailing Address
JOHAN W SOSA DE LA CRUZ MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number:
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