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Individual

PATRICK MWONYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6473 INDEPENDENCE CT, PENDLETON, IN 46064-8524
(732) 991-7056
Mailing address
6473 INDEPENDENCE CT, PENDLETON, IN 46064-8524
(732) 991-7056

Taxonomy

Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
263
IN
Enumeration date
06/17/2016
Last updated
06/17/2016
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