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1104261726
MARIE LOUISE FAGAN
SAN DIEGO, CA
NPI
1104261726
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2013-05-09
Last Update Date
2013-05-09
Business Address
-- MARIE LOUISE FAGAN IDC
4077 32ND ST APT 8
SAN DIEGO, CA 92104-2080
Phone number: 678-764-4067
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Mailing Address
-- MARIE LOUISE FAGAN IDC
4077 32ND ST APT 8
SAN DIEGO, CA 92104-2080
Phone number: 678-764-4067
Copy
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