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Individual

RANISSA LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1/2 MILE SW OF COVE CHAPTER HOUSE, RED VALLEY, AZ 86544
(505) 608-5805
(505) 564-2550
Mailing address
PO BOX 454, RED VALLEY, AZ 86544-0454
(505) 608-5805
(505) 564-2550

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
797515
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
797515
AZ
Enumeration date
04/01/2013
Last updated
04/01/2013
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