Individual
MR. JEFFREY EDWARD MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1000 EVERGREEN AVE, WEATHERLY, PA 18255-1530
(570) 427-4831
Mailing address
108 PUTNAM ST, TUNKHANNOCK, PA 18657-1029
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0C003429L
PA
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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