Individual
LISA MARIE CORRAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5034 KEVIN LN, SHASTA LAKE, CA 96019-9741
(530) 209-1837
Mailing address
5034 KEVIN LN, SHASTA LAKE, CA 96019-9741
(530) 209-1837
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
98476
CA
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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