Individual
FRED SOULES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17108 S MONO VISTA RD, SOULSBYVILLE, CA 95372-9750
(209) 532-2694
(209) 532-2694
Mailing address
17108 S MONO VISTA RD, SOULSBYVILLE, CA 95372-9750
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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