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General NPI Number Information
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NPI Number | 1134507965
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Entity Type | Individual
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Provider Name | CHRISSY M MANNING OD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 800 1ST ST
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City | CLEVELAND
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State | MS
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Zip | 38732
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Country | US
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Telephone | 662-579-3737
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Fax | 662-579-3505
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Provider Business Mailing Address
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Address Line | 239 S WASHINGTON AVE
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City | GREENVILLE
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State | MS
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Zip | 38701-4234
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Country | US
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Telephone | 662-332-0163
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Fax | 662-378-3394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-D31-TA-A02
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 953
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License Number State | MS
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