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1245713569
IMANI ISSA
TYLER, TX
NPI
1245713569
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2018-09-12
Last Update Date
2018-09-12
Business Address
IMANI ISSA
3900 UNIVERSITY BLVD
TYLER, TX 75799-6600
Phone number: 817-707-4208
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Mailing Address
IMANI ISSA
2366 STAGECOACH ST
FORT WORTH, TX 76133-8196
Phone number: 817-707-4208
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