Organization
LICE BUSTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMSON MAI (OWNER)
(559) 355-4216
Entity
Organization
Contact information
Practice address
1075 E BULLARD AVE STE 102, FRESNO, CA 93710-5532
(559) 540-8928
Mailing address
1075 E BULLARD AVE STE 102, FRESNO, CA 93710-5532
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
07/02/2019
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