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1164149761
HOLLY LOUISE BALTHAZOR
LOMIRA, WI
NPI
1164149761
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: WI 796-27)
Enumeration Date
2022-10-24
Last Update Date
2022-10-24
Business Address
HOLLY LOUISE BALTHAZOR
438 ASHFORD AVE
LOMIRA, WI 53048-9578
Phone number: 920-269-4386
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Mailing Address
HOLLY LOUISE BALTHAZOR
1048 HOLLY TREE LN
FOND DU LAC, WI 54935-8008
Phone number: 920-960-1985
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