Individual
JACQUELYN CELES MANZANILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
331 PAGE ST STE 2, STOUGHTON, MA 02072-1172
(781) 241-2782
Mailing address
331 PAGE ST STE 2, STOUGHTON, MA 02072-1172
(781) 241-2782
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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