Individual
MR. TAIWO OLUSEGUN FOWOWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2005 CLUB BAY DR, VILLA RICA, GA 30180-5136
(267) 575-5092
Mailing address
2005 CLUB BAY DR, VILLA RICA, GA 30180-5136
(267) 575-5092
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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