SHIRLEY PRASETYO BUNTORO

SAYRE, PA
NPI1831727239
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: TX  U4752)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-03-31
Last Update Date2023-07-19
Business Address
SHIRLEY PRASETYO BUNTORO DO
1 GUTHRIE SQ
SAYRE, PA 18840-1625
Phone number: 570-887-3585
Mailing Address
SHIRLEY PRASETYO BUNTORO DO
523 GREEN RIVER RD
WALNUT, CA 91789-1821
Phone number: