Individual
OLENA POLUEKTOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7959 COVERT LN, SEBASTOPOL, CA 95472-2757
(707) 829-3540
Mailing address
7959 COVERT LN, SEBASTOPOL, CA 95472-2757
(707) 829-3540
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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