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1972383750
ETHAN MARK FERGON
VALLEJO, CA
NPI
1972383750
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2023-09-29
Last Update Date
2024-08-09
Business Address
ETHAN MARK FERGON
908 TUOLUMNE ST
VALLEJO, CA 94590-4641
Phone number: 707-648-8121
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Mailing Address
ETHAN MARK FERGON
908 TUOLUMNE ST
VALLEJO, CA 94590-4641
Phone number: 707-648-8121
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