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1639720865
SHOUDLIE MANOTTE JOSEPH
PHILADELPHIA, PA
NPI
1639720865
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: FL 19-399)
Enumeration Date
2019-09-29
Last Update Date
2019-09-29
Business Address
SHOUDLIE MANOTTE JOSEPH SA-C
5811 BUSTLETON AVE
PHILADELPHIA, PA 19149-3405
Phone number: 347-444-0241
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Mailing Address
SHOUDLIE MANOTTE JOSEPH SA-C
5811 BUSTLETON AVE
PHILADELPHIA, PA 19149-3405
Phone number: 347-444-0241
Copy
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