GENETTA I DALLAS

LAKE CITY, FL
NPI1396918777
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: FL  pn5176094)
Enumeration Date2008-04-08
Last Update Date2018-02-21
Business Address
GENETTA I DALLAS LPN
808 NW WILSON ST
LAKE CITY, FL 32055-1867
Phone number: 386-292-4096
Mailing Address
GENETTA I DALLAS LPN
808 NW WILSON ST
LAKE CITY, FL 32055-1867
Phone number: 386-292-4096
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