Healthcare Provider Details

I. General information

NPI: 1659367241
Provider Name (Legal Business Name): MANNING FAMILY HEALTHCARE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 CENTER ST
MANNING IA
51455-1020
US

IV. Provider business mailing address

321 CENTER ST
MANNING IA
51455-1020
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-2551
  • Fax: 712-655-2579
Mailing address:
  • Phone: 712-655-2551
  • Fax: 712-655-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN A REINKE
Title or Position: CLINIC ADMINISTRATOR
Credential: BS-HCM, CMA-C
Phone: 712-655-2551