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General NPI Number Information
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NPI Number | 1508389735
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Entity Type | Organization
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Legal Business Name | LICE CLINICS OF AMERICA
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1329 E THOUSAND OAKS BLVD STE 128
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-6257
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Country | US
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Telephone | 805-807-3606
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Fax |
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Provider Business Mailing Address
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Address Line | 1329 E THOUSAND OAKS BLVD STE 128
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-6257
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Country | US
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Telephone | 805-807-3606
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI MARSHALL
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Credential |
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Telephone | 805-807-3606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State | CA
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