Individual
MARY BALDERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 W REX ALLEN DR, WILLCOX, AZ 85643-1009
(520) 384-3541
Mailing address
15650 E SONORAN PEAK TRL, VAIL, AZ 85641-8913
(928) 607-4681
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN158380
AZ
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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