Organization
UNDERCOVER ANGELS MOBILE PHLEBOTOMY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANEETAH VELMA PRIDGEN PC 60845589 (OWNER)
(253) 273-0571
Entity
Organization
Contact information
Practice address
17827 18TH AVENUE CT E, SPANAWAY, WA 98387-4119
(253) 273-0571
Mailing address
17827 18TH AVENUE CT E, SPANAWAY, WA 98387-4119
(253) 273-0571
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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