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1730590829
FRED FOMBRUN
HENDERSON, NV
NPI
1730590829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NV PA1527)
Enumeration Date
2014-05-12
Last Update Date
2014-05-12
Business Address
-- FRED FOMBRUN PA-C
2380 W HORIZON RIDGE PKWY STE 110
HENDERSON, NV 89052-5078
Phone number: 972-656-0493
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Mailing Address
-- FRED FOMBRUN PA-C
205 WINNSBORO ST
HENDERSON, NV 89074-7877
Phone number: 862-755-9418
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