MEDICARE: DR. ANDY C MANN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1226	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71292	OTHER	AL	PROVIDER NUMBER
2	1226	OTHER	AL	STATE LIC. NUMBER

General Provider Information

NPI Number	:	1346205473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDY C MANN DC

Provider Business Mailing Address
First Line	:	619 N BRINDLEE MOUNTAIN PKWY
Second Line	:
City	:	ARAB
State	:	AL
Zip	:	35016-1055
Country	:	US
Telephone Number	:	256-586-4147
Fax Number	:	256-586-4150

Provider Business Practice Location Address
First Line	:	619 N BRINDLEE MOUNTAIN PKWY
Second Line	:
City	:	ARAB
State	:	AL
Zip	:	35016-1055
Country	:	US
Telephone Number	:	256-586-4147
Fax Number	:	256-586-4150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. ANDY C MANN DC” Practice Location

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