Individual
LEA ROSE MANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC., DIPL. O.M.
Contact information
Practice address
6800 PITTSFORD PALMYRA RD STE 350, FAIRPORT, NY 14450-3503
(585) 598-3866
Mailing address
6800 PITTSFORD PALMYRA RD STE 350, FAIRPORT, NY 14450-3503
(585) 598-3866
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006834-01
NY
171100000X
Acupuncturist
25MZ00145900
NJ
Other
Enumeration date
10/19/2020
Last updated
05/01/2023
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