EBOT B MANGA

DACULA, GA
NPI1164920716
Professional NameEBOT B. MANGA
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: GA  147685)
Enumeration Date2018-01-29
Last Update Date2021-07-20
Business Address
EBOT B MANGA
2064 LILAC ARBOR WAY
DACULA, GA 30019-2475
Phone number: 678-887-4367
Mailing Address
EBOT B MANGA
2064 LILAC ARBOR WAY
DACULA, GA 30019-2475
Phone number: 678-887-4367
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