Individual
ALLEN BOSQUET FANGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5115 S 3RD ST, LOUISVILLE, KY 40214-2601
(502) 233-3030
Mailing address
5115 S 3RD ST, LOUISVILLE, KY 40214-2601
(502) 233-3030
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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