Individual
LAVERNE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 STATE ROAD 4, PINON, AZ 86510-1700
(505) 430-7389
Mailing address
PO BOX 602, PINON, AZ 86510-0602
(505) 430-7389
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
03/26/2023
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