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Individual

TEJAN W BANGURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13902 MATHEWS DR, WOODBRIDGE, VA 22191-2409
(571) 888-1824
Mailing address
5125 SPRING BRANCH BLVD, DUMFRIES, VA 22025-3046
(571) 888-1824

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
05/17/2018
Last updated
05/17/2018
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