Individual
KARINA BANDA-MANCILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16044 COUNTY ROAD 165, TYLER, TX 75703-7302
(903) 526-5599
Mailing address
19081 GREENLEAF DR, FLINT, TX 75762-9527
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2163185
TX
Other
Enumeration date
02/16/2024
Last updated
02/16/2024
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