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1790463883
TAE JEONG GONG
LAS VEGAS, NV
NPI
1790463883
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-07-07
Last Update Date
2023-07-07
Business Address
Mr. TAE JEONG GONG
1001 SHADOW LN
LAS VEGAS, NV 89106-4124
Phone number: 702-895-3011
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Mailing Address
Mr. TAE JEONG GONG
1001 SHADOW LN
LAS VEGAS, NV 89106-4124
Phone number:
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