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1164292918
RIVER LASSOTOVITCH
UKIAH, CA
NPI
1164292918
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-01-03
Last Update Date
2024-01-03
Business Address
RIVER LASSOTOVITCH
776 S STATE ST STE 103
UKIAH, CA 95482-5833
Phone number: 707-463-4915
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Mailing Address
RIVER LASSOTOVITCH
776 S STATE ST STE 103
UKIAH, CA 95482-5833
Phone number: 707-463-4915
Copy
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