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Individual

MAGDALENA ASUNCION BALTAZAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
94-904 KUAKAHI ST, WAIPAHU, HI 96797-2808
(180) 867-7496
Mailing address
94-904 KUAKAHI ST, WAIPAHU, HI 96797-2808
(180) 867-7496

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary

Other

Enumeration date
04/10/2007
Last updated
07/08/2007
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