AUGUSTINE NUBEA FOMBON

GRAND PRAIRIE, TX
NPI1033754890
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QP2000X Clinic/Center, Physical Therapy
Enumeration Date2019-11-14
Last Update Date2020-10-27
Business Address
AUGUSTINE NUBEA FOMBON
601 S GREAT SOUTHWEST PKWY STE 106
GRAND PRAIRIE, TX 75051-1057
Phone number: 214-718-9593
Mailing Address
AUGUSTINE NUBEA FOMBON
601 S GREAT SOUTHWEST PKWY STE 106
GRAND PRAIRIE, TX 75051-1057
Phone number: 214-718-9593