Individual
MISS MARIE LEE KATHLEEN JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
441 BAUCHET ST, LOS ANGELES, CA 90012-2906
(213) 972-2205
Mailing address
270 SAN MARCOS ST APT V, SAN GABRIEL, CA 91776-1046
(562) 756-4034
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
95000201
CA
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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