Individual
TIA TAQUESTA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 HOLLY AVE, MANCHESTER, NH 03103-4607
(561) 563-1973
Mailing address
105 HOLLY AVE, MANCHESTER, NH 03103-4607
(561) 563-1973
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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