Individual
WILLARD RAY SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17764 EUCALYPTUS ST, HESPERIA, CA 92345-5153
(760) 995-0069
Mailing address
17764 EUCALYPTUS ST, HESPERIA, CA 92345-5153
(760) 995-0069
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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