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1851152052
STEPHEN DEMOSTHENES FONSWORTH
CERES, CA
NPI
1851152052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-01-16
Last Update Date
2024-05-02
Business Address
STEPHEN DEMOSTHENES FONSWORTH
1708 BANYAN CT
CERES, CA 95307-1907
Phone number: 209-538-1888
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Mailing Address
STEPHEN DEMOSTHENES FONSWORTH
2935 4TH ST
CERES, CA 95307-3222
Phone number: 209-538-9009
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