Individual
MS. MIA MANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 SCARLET OAK LN APT 12, CHARLESTON, WV 25306-1129
(304) 657-8369
Mailing address
40 SCARLET OAK LN APT 12, CHARLESTON, WV 25306-1129
(304) 657-8369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
103520
WV
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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