Individual
STEPHANIE ANNE MANCEOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
244 SARANAC DR, SUNSET, SC 29685-1619
(713) 419-6547
Mailing address
244 SARANAC DR, SUNSET, SC 29685-1619
(713) 419-6547
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4137
TN
Other
Enumeration date
04/21/2020
Last updated
04/21/2020
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