Individual
CARLIE ROSE MANCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 631-4224
Mailing address
654 JOHNSON AVE, MERIDEN, CT 06451-2742
(203) 631-4224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9111148
FL
363A00000X
Physician Assistant
PA.0008541
CO
Other
Enumeration date
04/23/2018
Last updated
08/14/2024
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