Individual
BRENDALIZ VAZQUEZ GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8691 N WASILLA FISHHOOK RD, WASILLA, AK 99654-9077
(907) 315-5034
Mailing address
PO BOX 879455, WASILLA, AK 99687-9455
(907) 315-5034
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
RBT-19-97095
CO
Other
Enumeration date
10/26/2019
Last updated
10/26/2019
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