Individual
MARILYN MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 MANCHESTER AVE, STOCKTON, CA 95204-5029
(601) 493-4432
Mailing address
2405 MANCHESTER AVE, STOCKTON, CA 95204-5029
(601) 493-4432
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
CA
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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