Individual
IMAN JOSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 RIVER BEND DR, 19104, GEORGETOWN, TX 78628-3368
(512) 210-6888
(888) 665-0906
Mailing address
PO BOX 5245, ROUND ROCK, TX 78683-5245
(512) 210-6888
(888) 665-0906
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
802388923
TX
Other
Enumeration date
02/19/2016
Last updated
02/24/2016
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