Individual
ADA L MANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12440 IMPERIAL HWY, NORWALK, CA 90650-3177
(562) 565-6559
Mailing address
4605 E 52ND PL, MAYWOOD, CA 90270-2416
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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