ROSHALLY ELVY HUTABARAT

SAN BERNARDINO, CA
NPI1679760573
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164X00000X Licensed Vocational Nurse
(Licence: CA  VA 209395)
Enumeration Date2007-09-25
Last Update Date2007-09-25
Business Address
Mrs. ROSHALLY ELVY HUTABARAT LVN
264 E 18TH ST
SAN BERNARDINO, CA 92404-4708
Phone number: 909-883-0288
Mailing Address
Mrs. ROSHALLY ELVY HUTABARAT LVN
25502 PORTOLA LOOP
LOMA LINDA, CA 92354
Phone number: 909-796-2303
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