Individual
EDITHA MANUEL CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1473 GREY OWL CIR, ROSEVILLE, CA 95661-4005
(916) 517-8099
Mailing address
1473 GREY OWL CIR, ROSEVILLE, CA 95661-4005
(916) 517-8099
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
21583
CA
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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