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1831640929
PHALLY LANG
JACKSONVILLE, FL
NPI
1831640929
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QA0600X Clinic/Center, Adult Day Care
Enumeration Date
2016-10-24
Last Update Date
2016-10-24
Business Address
-- PHALLY LANG
542 EDGEWOOD AVE S
JACKSONVILLE, FL 32205-5333
Phone number: 978-495-1461
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Mailing Address
-- PHALLY LANG
542 EDGEWOOD AVE S
JACKSONVILLE, FL 32205-5333
Phone number: 978-495-1461
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