Healthcare Provider Details

I. General information

NPI: 1053203349
Provider Name (Legal Business Name): JAXON MANESS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2025
Last Update Date: 07/19/2025
Certification Date: 07/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR
HENDERSONVILLE NC
28792-5272
US

IV. Provider business mailing address

202 RUTLEDGE DR
HENDERSONVILLE NC
28739-6240
US

V. Phone/Fax

Practice location:
  • Phone: 855-774-5433
  • Fax:
Mailing address:
  • Phone: 704-985-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: