Individual
DIVINE LOVALA KUJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 S GREAT SOUTHWEST PKWY STE 106, GRAND PRAIRIE, TX 75051-1057
(214) 412-2528
Mailing address
601 S GREAT SOUTHWEST PKWY STE 106, GRAND PRAIRIE, TX 75051-1057
(214) 412-2528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1236233
TX
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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