Individual
PAVANI MANDAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
810 S BROOM ST, WILMINGTON, DE 19805-4245
(302) 652-1181
Mailing address
135 HAUT BRION AVE, NEWARK, DE 19702-4535
(302) 356-1755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002089
DE
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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