Individual
JOHN LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2625 COFFEE RD, SUITE S, MODESTO, CA 95355-2050
(209) 577-1200
(209) 577-6517
Mailing address
2625 COFFEE RD, SUITE S, MODESTO, CA 95355-2050
(209) 577-1200
(209) 577-6517
Taxonomy
Speciality
Code
Description
License number
State
246QH0600X
Histology Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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