Healthcare Provider Details

I. General information

NPI: 1639111370
Provider Name (Legal Business Name): ANTHONY MICHAEL MANES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 ROCHESTER RD
CRANBERRY TWP PA
16066-4350
US

IV. Provider business mailing address

2710 ROCHESTER RD STE 200
CRANBERRY TOWNSHIP PA
16066-6546
US

V. Phone/Fax

Practice location:
  • Phone: 724-779-0001
  • Fax: 724-779-0003
Mailing address:
  • Phone: 724-779-0001
  • Fax: 724-779-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009595
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: