Individual
TRAVONA FOMBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38551 METRO VILLA DR UNIT 105Y, HARRISON TWP, MI 48045-5386
(248) 291-7595
Mailing address
38551 METRO VILLA DR UNIT 105Y, HARRISON TWP, MI 48045-5386
(248) 291-7595
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
2300141167060408
MI
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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