Individual
MAMATA HOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2804 ROMER BLVD, POLLOCK PINES, CA 95726-9242
(855) 832-6727
Mailing address
1205 E 22ND ST APT 708, MARYSVILLE, CA 95901-3612
(530) 812-7946
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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