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Individual

LAVARSHIYA HOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
430 PERKINS AVE, MOUNT VERNON, IL 62864-5473
(618) 316-6164
Mailing address
430 PERKINS AVE, MOUNT VERNON, IL 62864-5473
(618) 316-6164

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary

Other

Enumeration date
08/02/2018
Last updated
08/02/2018
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