Individual
ALYCNE BOBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59136 KIDD RD, GLENWOOD, IA 51534-6130
(575) 621-9631
Mailing address
59136 KIDD RD, GLENWOOD, IA 51534-6130
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
684560
CA
Other
Enumeration date
05/18/2017
Last updated
05/18/2017
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