Individual
FRANK LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1650 N WASHINGTON AVE, DOUGLAS, AZ 85607-1848
(520) 364-2447
Mailing address
1132 E 12TH ST, DOUGLAS, AZ 85607-2337
(520) 364-2447
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN152613
AZ
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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