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Organization
PICC LINE ACCESS INC
Active
Organization
PICC LINE ACCESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAN A LAVELLE RN (OWNER)
(951) 533-3331
Entity
Organization
Contact information
Practice address
822 KILMARNOCK WAY, RIVERSIDE, CA 92508-6077
(951) 533-5551
Mailing address
822 KILMARNOCK WAY, RIVERSIDE, CA 92508-6077
(951) 533-5551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
424764
CA
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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