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1952946360
SHADOW LEE
FRESNO, CA
NPI
1952946360
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164X00000X Licensed Vocational Nurse
(Licence: CA 704476)
Enumeration Date
2019-11-08
Last Update Date
2019-11-08
Business Address
SHADOW LEE
4411 E KINGS CANYON RD
FRESNO, CA 93702-3604
Phone number: 559-453-1008
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Mailing Address
SHADOW LEE
4411 E KINGS CANYON RD
FRESNO, CA 93702-3604
Phone number: 559-453-1008
Copy
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