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Individual

WANDA R. CORPUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
94-380 LEHOPULU ST, WAIPAHU, HI 96797-1502
(808) 676-4561
(808) 676-4562
Mailing address
94-380 LEHOPULU ST, WAIPAHU, HI 96797-1502

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
09/28/2011
Last updated
09/28/2011
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