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1568007243
DALTON DAWAYNE NICHOLS
LOS ANGELES, CA
NPI
1568007243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-11-17
Last Update Date
2019-11-17
Business Address
DALTON DAWAYNE NICHOLS
13029 STANFORD AVE
LOS ANGELES, CA 90059-3339
Phone number: 424-366-9509
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Mailing Address
DALTON DAWAYNE NICHOLS
13029 STANFORD AVE
LOS ANGELES, CA 90059-3339
Phone number: 424-366-9509
Copy
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