Individual
MR. JOSUE PRADO JABOLA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1723 CHARITY LN, FAYETTEVILLE, NC 28304-4735
(910) 670-6864
Mailing address
1723 CHARITY LN, FAYETTEVILLE, NC 28304-4735
(910) 670-6864
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14585
NC
Other
Enumeration date
05/21/2016
Last updated
05/22/2016
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