Individual
KANGNI SERGE FOLLY-NOTSRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7920 MOCCASIN TRAIL DR, RIVERVIEW, FL 33578-8611
(402) 321-6965
Mailing address
7920 MOCCASIN TRAIL DR, RIVERVIEW, FL 33578-8611
(402) 321-6965
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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