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1346641818
SAMANTHA STAVOLA
PHILADELPHIA, PA
NPI
1346641818
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: PA DN004879)
Enumeration Date
2014-09-15
Last Update Date
2014-09-15
Business Address
-- SAMANTHA STAVOLA
1512 SOUTH ST
PHILADELPHIA, PA 19146-1636
Phone number: 267-239-5637
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Mailing Address
-- SAMANTHA STAVOLA
10905 KIRBY DR
PHILADELPHIA, PA 19154-4205
Phone number:
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