Individual
MANUELLA D KHOSHABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7201 W CAMINO SAN XAVIER, GLENDALE, AZ 85308-3798
(623) 703-2748
Mailing address
7201 W CAMINO SAN XAVIER, GLENDALE, AZ 85308-3798
(623) 703-2748
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
013818
AZ
Other
Enumeration date
04/10/2019
Last updated
02/03/2021
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