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General NPI Number Information
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NPI Number | 1114145190
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Entity Type | Organization
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Legal Business Name | FONDAS THERAPY BILLING
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 259 W ALLEN ST
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City | BRAWLEY
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State | CA
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Zip | 92227-3101
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Country | US
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Telephone | 760-344-2764
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Fax | 760-344-8240
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Provider Business Mailing Address
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Address Line | 259 W ALLEN ST
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City | BRAWLEY
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State | CA
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Zip | 92227-3101
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Country | US
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Telephone | 760-344-2764
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Fax | 760-344-8240
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Authorized Official
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Title or Position | OWNER
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Name | FONDA K HOWINGTON
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Credential |
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Telephone | 760-344-2764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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