Individual
JESSICA MANZOLILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
175 S WILKES BARRE BLVD, WILKES BARRE, PA 18702-5040
(570) 208-6281
(570) 208-6282
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA051051
PA
363AM0700X
Medical Physician Assistant
MA051051
PA
Other
Enumeration date
11/14/2005
Last updated
07/31/2020
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