Organization
EXPRESSLY YOURS LACTATION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A MARASCO MA IBCLC (OWNER)
(805) 937-9717
Entity
Organization
Contact information
Practice address
4452 VILLAGE KNOLL DR, SANTA MARIA, CA 93455-4012
(805) 937-9717
Mailing address
4452 VILLAGE KNOLL DR, SANTA MARIA, CA 93455-4012
(805) 937-9717
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02212F
—
CA
Enumeration date
05/14/2007
Last updated
08/22/2020
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