NPI 1235607011

Jose Luis Gonzales, COBOCO

Practitioner Orthotist Mequon, WI

Practice location

Address: 12075 Corporate Pkwy STE 120, Mequon, WI 53092-2664
Phone: (262) 643-4418
Mailing address: 20225 Sutter Creek Dr APT 208, Brookfield, WI 53045-3931

Registered specialties

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1235607011
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Nov 2018
Record last updated: 9 Nov 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.