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Individual

KAREN DENISE LOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3013 TULLY RD, MODESTO, CA 95350-0806
(209) 408-8399
(209) 408-8399
Mailing address
3013 TULLY RD, MODESTO, CA 95350-0806
(209) 408-8399
(209) 408-8399

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
024055060
CA

Other

Enumeration date
05/27/2010
Last updated
05/27/2010
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