Individual
ALLIE LAURIE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
1453 16TH ST, SANTA MONICA, CA 90404-2715
(310) 309-6001
Mailing address
1453 16TH ST, SANTA MONICA, CA 90404-2715
(310) 309-6001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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