Jose Ebrique Riesgo, PBMT

NPI #1043585490 in Livonia, Michigan

Provider Information

NPI Number: 1043585490
Entity Type: Individual
Name: Jose Ebrique Riesgo, PBMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Perfusionist
Credential: PBMT
Enumeration Date: Mar 19, 2012
Last Updated: Mar 19, 2012

Practice Location

Address: 31330 SCHOOLCRAFT RD
Address 2: STE 200
City: Livonia
State: Michigan
ZIP Code: 48150-2041
Phone: (734) 525-9712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Perfusionist	242T00000X	Primary

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