MUTIAT B BAMGBALA

LEXINGTON, NC
NPI1205528635
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy347C00000X Private Vehicle
(Licence: NC  000048761695)
Additional Taxonomies342000000X 
(Licence: NC  000048761695)
Enumeration Date2023-05-24
Last Update Date2023-10-06
Business Address
MUTIAT B BAMGBALA PROVIDER
254 ASHFIELD LN
LEXINGTON, NC 27292-8348
Phone number: 860-986-0003
Mailing Address
MUTIAT B BAMGBALA PROVIDER
355 FAITH RD
SALISBURY, NC 28146-7007
Phone number: 860-986-0003
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