Individual
MAXINE SEABORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 LEMON ST, RIVERSIDE, CA 92501-2861
(951) 686-8204
Mailing address
4426 MICHAEL ST, RIVERSIDE, CA 92507-5228
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
21007
CA
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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