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Individual

LONNIE GOVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6248 NARROW ISTHMUS AVE, LAS VEGAS, NV 89139-6410
(510) 963-7155
Mailing address
8605 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4109

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
194700959
CA

Other

Enumeration date
04/25/2023
Last updated
04/25/2023
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