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Individual

THERMON LENELLE CARRIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1332 W. 254TH ST, APT E, HARBOR CITY, CA 90710
(310) 947-7051
Mailing address
1332 W 254TH STREET, APT E, HARBOR CITY, CA 90710

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
N8866078
CA

Other

Enumeration date
07/27/2012
Last updated
07/27/2012
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Product
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