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Individual

MS. JO MANETTE KATHLEEN NOUSAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH. D.

Contact information

Practice address
170 INTREPID LN, SYRACUSE, NY 13205-2545
(315) 492-8319
Mailing address
170 INTREPID LN, SYRACUSE, NY 13205-2545
(315) 492-8319

Taxonomy

Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
000813-1
NY

Other

Enumeration date
01/03/2008
Last updated
01/03/2008
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