BO GONG

KISSIMMEE, FL
NPI1407115835
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL  MA68483)
Enumeration Date2012-05-04
Last Update Date2012-05-04
Business Address
Mr. BO GONG
2579 OAK ST
KISSIMMEE, FL 34744-4946
Phone number: 407-288-4865
Mailing Address
Mr. BO GONG
2579 OAK ST
KISSIMMEE, FL 34744-4946
Phone number: 407-288-4865
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