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Tom Ishengoma
NPI 1558135574 · on the registry since 2023 · sole proprietor
Practice
- Address
- 19535 N 55th Dr
Glendale, AZ 85308 - Phone
- (614) 966-0671
- Organisation at this address
- Lakeshore Crest,Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 310400000X
310400000X
- Sex
- Male
- Record last updated
- 2023-11-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona