Individual
MR. AJUSEH NKENG FORTABOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
7758 DEERCREST CT, DUBLIN, OH 43016-9280
(614) 515-9284
Mailing address
7758 DEERCREST CT, DUBLIN, OH 43016-9280
(614) 515-9284
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-136989-IV
OH
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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