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1336987601
IMMANUELLE PONGO
ATLANTA, GA
NPI
1336987601
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-07-19
Last Update Date
2024-07-19
Business Address
IMMANUELLE PONGO
720 WESTVIEW DR SW
ATLANTA, GA 30310-1458
Phone number: 404-756-1959
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Mailing Address
IMMANUELLE PONGO
4778 SULTANA WAY SW
ATLANTA, GA 30331-7506
Phone number: 239-270-9645
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