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Individual

LEEARLIS ARCHIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA, MAA

Contact information

Practice address
1021 STAFFORD PLACE CIRCLE, APT #104, WINSTON-SALEM, NC 27127
(336) 995-0397
(336) 306-9763
Mailing address
1021 STAFFORD PLACE CIRCLE, APT #104, WINSTON-SALEM, NC 27127
(336) 995-0397
(336) 306-9763

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
M108189
NC

Other

Enumeration date
08/27/2021
Last updated
08/27/2021
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