Doctor Name: | LESA RENEE NOBILING |
NPI Number: | 1003033382 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 3245 Fletcher Ave Lake City, IA - 514497561 |
Business Phone Number: | 7124647279 |
Business Fax Number: | |
Mailing Address: | 3245 Fletcher Ave, LAKE CITY |
State: | IA |
Postal Code: | 514497561 |
Phone Number: | 7124647279 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |