Lice Avengers of SW Florida LLC
NPI #1730687070 in Bonita Springs, Florida
Provider Information
- NPI Number
- 1730687070
- Entity Type
- Organization
- Organization Name
- Lice Avengers of SW Florida LLC
- Primary Specialty
- Technician, Other
- Enumeration Date
- Jan 31, 2018
- Last Updated
- Jan 31, 2018
Practice Location
- Address
- 8881 TERRENE CT STE 104
- City
- Bonita Springs
- State
- Florida
- ZIP Code
- 34135-9528
- Phone
- (239) 237-0757
Authorized Official
- Name
- MR. JEFFREY RANDOLPH
- Title
- OWNER
- Phone
- (608) 509-6807
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician, Other |
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