Individual
MANGA FOMBUH TITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8194 COLYN CT, LIBERTY TOWNSHIP, OH 45044-8752
(513) 237-0119
Mailing address
8194 COLYN CT, LIBERTY TOWNSHIP, OH 45044-8752
(513) 237-0119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
355688
OH
163WA2000X
Administrator Registered Nurse
Primary
355688
OH
163WG0600X
Gerontology Registered Nurse
355688
OH
163WH0200X
Home Health Registered Nurse
355688
OH
Other
Enumeration date
06/18/2017
Last updated
07/21/2022
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