Individual
HOLIS GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31764 CASINO DR, STE 300, LAKE ELSINORE, CA 92530-4571
(951) 471-4645
(951) 471-4687
Mailing address
31764 CASINO DR, STE 300, LAKE ELSINORE, CA 92530-4571
(951) 471-4645
(951) 471-4687
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
260944
CA
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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