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1245935204
MARTIN NGU KWALE PONG
PHOENIX, AZ
NPI
1245935204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AZ 280285)
Enumeration Date
2023-03-31
Last Update Date
2023-04-05
Business Address
Mr. MARTIN NGU KWALE PONG PMHNP-BC
4338 W THOMAS RD
PHOENIX, AZ 85031-3878
Phone number: 682-307-0864
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Mailing Address
Mr. MARTIN NGU KWALE PONG PMHNP-BC
4338 W THOMAS RD
PHOENIX, AZ 85031-3878
Phone number: 682-307-0864
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