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1740562081
FARGO MICHAEL LIVINGSTON
VENICE, CA
NPI
1740562081
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2011-09-13
Last Update Date
2011-09-13
Business Address
Mr. FARGO MICHAEL LIVINGSTON b.a.
717 LINCOLN BLVD
VENICE, CA 90291-2845
Phone number: 310-399-9883
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Mailing Address
Mr. FARGO MICHAEL LIVINGSTON b.a.
717 LINCOLN BLVD
VENICE, CA 90291
Phone number: 310-399-9883
Copy
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