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1972584209
MELISSA JOYANN FORTNER
SAN DIEGO, CA
NPI
1972584209
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Former Name
MELISSA JOYANN WILENSKY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: CA PA15119)
Enumeration Date
2005-11-14
Last Update Date
2007-07-08
Business Address
Mrs. MELISSA JOYANN FORTNER PAC
4290 POLK AVE
SAN DIEGO, CA 92105-1524
Phone number: 619-563-0507
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Mailing Address
Mrs. MELISSA JOYANN FORTNER PAC
4290 POLK AVE
SAN DIEGO, CA 92105-1524
Phone number: 619-563-0507
Copy
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