MR. Shenan Lark
NPI #1104211655 in Angel Fire, New Mexico
Provider Information
- NPI Number
- 1104211655
- Entity Type
- Individual
- Name
- MR. Shenan Lark
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Private Vehicle
- Enumeration Date
- Apr 1, 2015
- Last Updated
- Apr 1, 2015
Practice Location
- Address
- 28 ASPEN ST. # 205
- City
- Angel Fire
- State
- New Mexico
- ZIP Code
- 87710
- Phone
- (505) 603-9282
Specialties & Taxonomy Codes
| Specialty |
|---|
| Personal Emergency Response Attendant |
| Driver |
| Private Vehicle |
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