Individual
MS. DIVINE MANSIBA MAGANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 NE 3RD AVE, MILTON FREEWATER, OR 97862
(541) 938-5693
Mailing address
910 COWL ST, #21, MILTON FREEWATER, OR 97862
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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