Individual
MR. STAN ELIJAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
4565 QUAIL LAKES DR STE A1, STOCKTON, CA 95207-5294
(209) 888-8602
(209) 888-8603
Mailing address
4565 QUAIL LAKES DR STE A1, STOCKTON, CA 95207-5294
(209) 888-8602
(209) 888-8603
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
201438
CA
Other
Enumeration date
01/20/2010
Last updated
01/20/2010
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