Individual
MR. RAYMOND PAMPOLINA MANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
905 LA MIRADA, PORTLAND, TX 78374-4130
(361) 776-4569
Mailing address
905 LA MIRADA, PORTLAND, TX 78374-4130
(361) 776-4569
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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