Individual
JALESA MANLEY WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 PECAN DR APT 402, ROANOKE RAPIDS, NC 27870-8207
(252) 326-4808
Mailing address
80 PECAN DR APT 402, ROANOKE RAPIDS, NC 27870-8207
(252) 673-7913
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NC
Other
Enumeration date
01/03/2018
Last updated
11/18/2020
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