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1295254597
VICENTE EDWARD LIZAMA
EUREKA, CA
NPI
1295254597
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-09-18
Last Update Date
2017-09-18
Business Address
VICENTE EDWARD LIZAMA
2259 MYRTLE AVE
EUREKA, CA 95501-3325
Phone number: 707-444-8293
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Mailing Address
VICENTE EDWARD LIZAMA
2259 MYRTLE AVE
EUREKA, CA 95501-3325
Phone number: 707-444-8293
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