GALLUS LEREH FOTABONG

LYNN, MA
NPI1821755513
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LG0600X Nurse Practitioner Gerontology
(Licence: MA  AG11210066)
Enumeration Date2021-11-17
Last Update Date2021-11-17
Business Address
MR. GALLUS LEREH FOTABONG
41 HARVEST ST
LYNN, MA 01902-1122
Phone number: 781-244-8473
Mailing Address
MR. GALLUS LEREH FOTABONG
41 HARVEST ST
LYNN, MA 01902-1122
Phone number: 781-244-8473
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