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Individual

ELEONORA KACZMAREK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2505 S 116TH AVE, AVONDALE, AZ 85323
(623) 444-9097
Mailing address
2505 S 116TH AVE, AVONDALE, AZ 85323-7638
(623) 444-9097

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
AL8568H
AZ

Other

Enumeration date
12/05/2012
Last updated
12/05/2012
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