Individual
LANA SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
526 RED TAIL TRL, LIVERMORE, CO 80536-9509
(970) 682-7769
Mailing address
526 RED TAIL TRL, LIVERMORE, CO 80536-9509
(970) 682-7769
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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