Individual
SHANTWANA S LYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2807 FOREST HOLLOW LN APT 3313, ARLINGTON, TX 76006-3020
(909) 485-2273
Mailing address
2807 FOREST HOLLOW LN APT 3313, ARLINGTON, TX 76006-3020
(909) 485-2273
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
KK546154
CA
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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