JED EDISON MANCE EVANGELISTA

KEW GARDENS, NY
NPI1215592845
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
Enumeration Date2019-05-09
Last Update Date2019-05-09
Business Address
Mr. JED EDISON MANCE EVANGELISTA PT
8532 125TH ST
KEW GARDENS, NY 11415-3311
Phone number: 410-629-9872
Mailing Address
Mr. JED EDISON MANCE EVANGELISTA PT
8532 125TH ST
KEW GARDENS, NY 11415-3311
Phone number: 410-629-9872
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