SOSTHENE MBALLA NDOMO

ALEXANDRIA, VA
NPI1750050522
Former NameSOSTHENE NDOMO MBALLA
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: VA  0024182625)
Enumeration Date2021-09-07
Last Update Date2021-09-07
Business Address
Mr. SOSTHENE MBALLA NDOMO NP
6463 ROCKSHIRE CT
ALEXANDRIA, VA 22315-3428
Phone number: 571-208-6962
Mailing Address
Mr. SOSTHENE MBALLA NDOMO NP
6463 ROCKSHIRE CT
ALEXANDRIA, VA 22315-3428
Phone number: 571-208-6962