Individual
LAKEITHA BELLMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4515 S MCCLINTOCK DR STE 212, TEMPE, AZ 85282-7382
(254) 370-1210
Mailing address
4515 S MCCLINTOCK DR STE 212, TEMPE, AZ 85282-7382
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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