SHENAN LARK

ANGEL FIRE, NM
NPI1104211655
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy347C00000X Private Vehicle
Additional Taxonomies146D00000X Personal Emergency Response Attendant
172A00000X Driver
Enumeration Date2015-04-01
Last Update Date2015-04-01
Business Address
MR. SHENAN LARK
28 ASPEN ST. # 205
ANGEL FIRE, NM 87710
Phone number: 505-603-9282
Mailing Address
MR. SHENAN LARK
PO BOX 1522
ANGEL FIRE, NM 87710-1522
Phone number: 505-603-9282