OBSIDIAN BLACKWOLF

HUNTINGTON PARK, CA
NPI1043010069
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2025-03-18
Last Update Date2025-08-13
Business Address
OBSIDIAN BLACKWOLF
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255-3699
Phone number: 323-346-0960
Mailing Address
OBSIDIAN BLACKWOLF
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255-3699
Phone number:
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