Individual
LEZIYA BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 2344, RANCHO CORDOVA, CA 95741-2344
(510) 899-1058
Mailing address
PO BOX 2344, RANCHO CORDOVA, CA 95741-2344
(510) 899-1058
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
CA
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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