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Individual

KEONA LASHAWN WAFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
140 B ST # 5-142, DAVIS, CA 95616-4653
(530) 204-9818
Mailing address
140 B ST # 6-142, DAVIS, CA 95616-4653
(530) 204-8918

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
08/04/2021
Last updated
06/23/2022
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