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1407115835
BO GONG
KISSIMMEE, FL
NPI
1407115835
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: FL MA68483)
Enumeration Date
2012-05-04
Last Update Date
2012-05-04
Business Address
Mr. BO GONG
2579 OAK ST
KISSIMMEE, FL 34744-4946
Phone number: 407-288-4865
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Mailing Address
Mr. BO GONG
2579 OAK ST
KISSIMMEE, FL 34744-4946
Phone number: 407-288-4865
Copy
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