STACEY BASKERVILLE

SWEENY, TX
NPI1417099565
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy146M00000X Emergency Medical Technician, Intermediate
(Licence: TX  139905)
Enumeration Date2007-02-13
Last Update Date2007-07-08
Business Address
STACEY BASKERVILLE
300 SILVERLEAF RD APT 1201
SWEENY, TX 77480-1839
Phone number: 979-482-4637
Mailing Address
STACEY BASKERVILLE
300 SILVERLEAF RD APT 1201
SWEENY, TX 77480-1839
Phone number: 979-482-4637