Organization
FAIRY DOG MOTHER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEISA R GRAJEK HHP (OWNER)
(760) 617-9229
Entity
Organization
Contact information
Practice address
1503 RIVERVIEW DR, FALLBROOK, CA 92028-1857
(760) 617-9229
Mailing address
1503 RIVERVIEW DR, FALLBROOK, CA 92028-1857
(760) 617-9229
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
11410
CA
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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