Individual
SANDRA LARIBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
618 FOSTER LN, MT JULIET, TN 37122-3198
(843) 364-5681
Mailing address
618 FOSTER LN, MT JULIET, TN 37122-3198
(843) 364-5681
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/30/2021
Last updated
01/30/2021
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