CAMIA CUSTODIO

Clinic/Center

Active Individual
NPI: 1730520644

Practice Address

301 S 4TH ST
San Jose, IL 62682

Phone: (309) 247-1203

Specialties

Specialty Code Primary License
Clinic/Center 261Q00000X Yes -

Frequently Asked Questions

NPI 1730520644 is the National Provider Identifier for CAMIA CUSTODIO, a Clinic/Center provider located in San Jose, IL. This NPI was enumerated on July 9, 2013.
CAMIA CUSTODIO practices at 301 S 4TH ST, San Jose, IL 62682.

Quick Facts

NPI
1730520644
Type
Individual
Enumerated
Jul 9, 2013
Last Updated
Jul 9, 2013

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