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1740585744
JOAN MARIE FAVOR WALLICK
LOS ANGELES, CA
NPI
1740585744
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: CA 376353)
Enumeration Date
2011-01-21
Last Update Date
2011-01-21
Business Address
-- JOAN MARIE FAVOR WALLICK BSN
824 N HILL ST
LOS ANGELES, CA 90012-2321
Phone number: 909-762-3606
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Mailing Address
-- JOAN MARIE FAVOR WALLICK BSN
4634 FOX GLEN AVE
LA VERNE, CA 91750-1836
Phone number: 909-599-4328
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