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Individual

CLIFF CHWEYA MICHOMA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1006 WORTHINGTON DR, EXTON, PA 19341-1650
(610) 701-1034
Mailing address
1006 WORTHINGTON DR, EXTON, PA 19341-1650
(610) 701-1034

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
MP
171W00000X
Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
979
PA
Enumeration date
09/14/2022
Last updated
09/14/2022
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