Individual
DEBRA LYNN SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-0842
(928) 846-4466
(928) 846-4465
Mailing address
116 LAKE HAVASU AVE S, LAKE HAVASU CITY, AZ 86403-0842
(928) 846-4466
(928) 846-4465
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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