Individual
LACI CHRISTINE VISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7821 LLANO AVE, FORT WORTH, TX 76116-1461
(817) 223-6644
Mailing address
7821 LLANO AVE, FORT WORTH, TX 76116-1461
(817) 223-6644
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
952952
TX
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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