Individual
ILLYA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.V.N.
Contact information
Practice address
916 SHOAL CREEK DR, ARLINGTON, TX 76001-7481
(817) 323-4872
Mailing address
916 SHOAL CREEK DR, ARLINGTON, TX 76001-7481
(817) 323-4872
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
210588
TX
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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