Individual
MR. AYODEJI A ILESANMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
3208 RANCHLAND DR, MIDLAND, TX 79705-5716
(432) 416-6198
Mailing address
3208 RANCHLAND DR, MIDLAND, TX 79705-5716
(432) 416-6198
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
301745
TX
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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