Individual
MR. GLENN RYAN MANSUETO NASARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1983 PRICE ST, RAHWAY, NJ 07065-4236
(732) 406-8299
Mailing address
1983 PRICE ST, RAHWAY, NJ 07065-4236
(732) 406-8299
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01301800
NJ
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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