Individual
LORI L DEYSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12033 AGENCY ROAD, PARKER, AZ 85344-7718
(928) 669-2137
Mailing address
12033 AGENCY ROAD, PARKER, AZ 85344
(928) 669-2137
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP043729
AZ
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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