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Individual

MR. GREGORY M FASHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1831 17TH CT N, LAKE WORTH, FL 33460-6437
(855) 832-6727
Mailing address
2902 SW 21ST TER # D1, DELRAY BEACH, FL 33445-7354
(561) 441-7353

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
FL

Other

Enumeration date
07/17/2017
Last updated
03/17/2018
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