Individual
MR. GLENN TWAIN MANANSALA DELROSARIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
174 OVERLOOK CT, WOODBRIDGE, NJ 07095-1454
(732) 306-8521
Mailing address
174 OVERLOOK CT, WOODBRIDGE, NJ 07095-1454
(732) 306-8521
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0007389
NY
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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