Organization
KANYONGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONCILLIA KANYONGO (REGISTERED NURSE)
(614) 446-0166
Entity
Organization
Contact information
Practice address
4075 FOREST EDGE DR, GAHANNA, OH 43230-1015
(614) 446-0166
Mailing address
4075 FOREST EDGE DR, GAHANNA, OH 43230-1015
(614) 446-0166
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
397097
OH
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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