Individual
ANDREA BEVERLY MANACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
76 PHOENIX ST, CANANDAIGUA, NY 14424-2025
(585) 831-3968
Mailing address
76 PHOENIX ST, CANANDAIGUA, NY 14424-2025
(585) 831-3968
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
288948-1
NY
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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