Individual
JENNA MUNDENAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
147 OLD NEWPORT ST, NANTICOKE, PA 18634-1327
(570) 740-5391
Mailing address
147 OLD NEWPORT ST, NANTICOKE, PA 18634-1327
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI005382
PA
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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