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Individual

MRS. ANITA LOUISE ALCORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
25003 BASEL DRIVE, CRESTLINE, CA 92325-3879
(909) 338-0274
Mailing address
PO BOX 3879, CRESTLINE, CA 92325-3879
(909) 338-0274

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
526364
CA

Other

Enumeration date
08/19/2008
Last updated
08/19/2008
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