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Individual

MR. KEVIN DARNEIL LASLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
313 E 113TH ST, LOS ANGELES, CA 90061-3019
(323) 418-8113
(323) 920-7691
Mailing address
313 E 113TH ST, LOS ANGELES, CA 90061-3019
(323) 418-8113
(323) 920-7691

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
A3975427
CA

Other

Enumeration date
02/21/2008
Last updated
02/21/2008
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