Individual
ANDREA ROSEANN PONSCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11027 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601-2431
(818) 985-8323
(818) 763-7574
Mailing address
11027 BURBANK BLVD, NORTH HOLLYWOOD, CA 91601-2431
(818) 985-8323
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
R36271214
CA
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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