Individual
MR. ADENIYI O OLUSOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4004 GREENWOOD WAY, MANSFIELD, TX 76063
(848) 203-7728
Mailing address
4004 GREENWOOD WAY, MANSFIELD, TX 76063-5560
(848) 203-7728
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
DONT HAVE
—
Enumeration date
06/08/2017
Last updated
07/21/2022
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