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Organization
LICE GIRLS, LLC
Active
Organization
LICE GIRLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HAGMAN (OWNER)
(360) 813-5472
Entity
Organization
Contact information
Practice address
2458 E PHINNEY BAY DR, BREMERTON, WA 98312-2730
(855) 542-3447
Mailing address
2458 E PHINNEY BAY DR, BREMERTON, WA 98312-2730
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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