Provider Demographics
NPI:1104518836
Name:ROJO, IRVING
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:
Last Name:ROJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 CESSNA LN
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8139
Mailing Address - Country:US
Mailing Address - Phone:828-216-3160
Mailing Address - Fax:
Practice Address - Street 1:1406 CESSNA LN
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8139
Practice Address - Country:US
Practice Address - Phone:828-216-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000035579802347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle