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Individual

ASHLEY MANISAP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
950 LAS GALLINAS AVE, SAN RAFAEL, CA 94903
(415) 479-6111
Mailing address
2280 RIDGEMERE CIR, ROSEVILLE, CA 95747-9095
(916) 770-9204

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
90372
CA

Other

Enumeration date
12/04/2024
Last updated
12/04/2024
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