JUNIOR FORMUKONG MBIPEH

NEWTOWN SQUARE, PA
NPI1144975178
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: FL  18734)
Enumeration Date2022-02-17
Last Update Date2024-04-30
Business Address
JUNIOR FORMUKONG MBIPEH COTA/L
3500 W CHESTER PIKE
NEWTOWN SQUARE, PA 19073-4101
Phone number: 610-359-4400
Mailing Address
JUNIOR FORMUKONG MBIPEH COTA/L
110 NORTHWEST 135TH WAY BLDG. 46 APT 301
PLANTATION, FL 33325
Phone number: 214-986-0857
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