Individual
NELLY MANTIZIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2717 W AVENUE L, LANCASTER, CA 93536-4057
(661) 943-8270
(661) 943-8396
Mailing address
2717 W AVENUE L, LANCASTER, CA 93536-4057
(661) 943-8270
(661) 943-8396
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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