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1659678167
KYLE BRUCE FORTSON
ARCADIA, CA
NPI
1659678167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-02-17
Last Update Date
2011-04-08
Business Address
Mr. KYLE BRUCE FORTSON
12310 LOWER AZUSA RD
ARCADIA, CA 91006-5872
Phone number: 626-579-8506
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Mailing Address
Mr. KYLE BRUCE FORTSON
12310 LOWER AZUSA RD
ARCADIA, CA 91006-5872
Phone number: 626-579-8506
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