Individual
WANNA STEPHANIE JEAN MARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 864-4031
Mailing address
5800 LAURENT DR APT 622, PARMA, OH 44129-5971
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0000
PA
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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