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1538933312
JORDAN MONTGOMERY VASU
LOMA LINDA, CA
NPI
1538933312
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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
2023-11-13
Last Update Date
2023-11-13
Business Address
JORDAN MONTGOMERY VASU
11130 ANDERSON ST
LOMA LINDA, CA 92350-1729
Phone number: 909-558-8577
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Mailing Address
JORDAN MONTGOMERY VASU
25 MERCATO
LAGUNA NIGUEL, CA 92677-8916
Phone number: 949-677-2373
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