John Henry Martin Lico

NPI #1003432667 in Surprise, Arizona

Provider Information

NPI Number
1003432667
Entity Type
Individual
Name
John Henry Martin Lico
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Assisted Living Facility
Enumeration Date
Jun 19, 2020
Last Updated
Jun 19, 2020

Practice Location

Address
15244 W WATSON LN
State
Arizona
ZIP Code
85379-7040
Phone
(623) 227-9697

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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