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1588856447
SIA GBONGBOR
PLYMOUTH MEETING, PA
NPI
1588856447
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MD LP35758)
Enumeration Date
2007-08-15
Last Update Date
2007-08-15
Business Address
-- SIA GBONGBOR LPN
2250 HICKORY RD SUITE 240
PLYMOUTH MEETING, PA 19462-1047
Phone number: 610-834-1122
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Mailing Address
-- SIA GBONGBOR LPN
6700 BELCREST RD APT. 1025
HYATTSVILLE, MD 20782-1398
Phone number:
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