Individual
MR. MENSA KAMAUGOGO MUATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
750 ALMAR PKWY, SUITE 205, BOURBONNAIS, IL 60914-2315
(815) 933-3955
(815) 933-3944
Mailing address
731 DOUBLE JACK ST, APT F, BOURBONNAIS, IL 60914-9214
(815) 549-2302
(815) 933-3944
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
IL
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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