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Organization

LACEDBYLISE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLLISE WASHINGTON (OWNER)
(816) 775-3239
Entity
Organization

Contact information

Practice address
3839 NW 85TH TER APT E, KANSAS CITY, MO 64154-3796
(816) 775-3239
Mailing address
3839 NW 85TH TER APT E, KANSAS CITY, MO 64154-3796
(816) 775-3239

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
09/20/2021
Last updated
09/20/2021
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