Organization
OTHER SIDE LACTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA BLAKE RN, IBCLC (OWNER)
(520) 349-7745
Entity
Organization
Contact information
Practice address
4838 E GLENN ST, TUCSON, AZ 85712-1237
(520) 349-7745
Mailing address
4838 E GLENN ST, TUCSON, AZ 85712-1237
(520) 349-7745
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
AZ
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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