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NPI Code Detail

MEDICARE: JANNA MANN

MEDICARE: JANNA MANN
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
1225100000XPhysical Therapist6963971-2401UT

General Provider Information

NPI Number : 1972763282
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNA MANN
Provider Business Mailing Address
First Line : PO BOX 682226
Second Line :
City : PARK CITY
State : UT
Zip : 84068-2226
Country : US
Telephone Number : 435-645-9095
Fax Number : 435-645-9092
Provider Business Practice Location Address
First Line : 2015 SIDEWINDER DR
Second Line :
City : PARK CITY
State : UT
Zip : 84060-7323
Country : US
Telephone Number : 435-645-9095
Fax Number : 435-645-9092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2008
Last Update Date : 11/23/2021

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Directions to “ JANNA MANN ” Practice Location

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