Individual
KELLY A HANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTC
Contact information
Practice address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
Mailing address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
(949) 540-7154
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
CA
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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