Individual
MR. KOMITSE GBOHLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3534 70TH ST APT 302, MOLINE, IL 61265-8236
(310) 866-5446
Mailing address
3534 70TH ST APT 302, MOLINE, IL 61265-8236
(310) 866-5446
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
05/21/2025
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