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General NPI Number Information
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NPI Number | 1326214222
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Entity Type | Organization
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Legal Business Name | JAMES H. MANASCO, OD PC
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 1900 11TH AVE SUITE B
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City | HALEYVILLE
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State | AL
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Zip | 35565-1552
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Country | US
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Telephone | 205-486-4321
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Fax | 205-486-4341
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Provider Business Mailing Address
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Address Line | 1900 11TH AVE SUITE B
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City | HALEYVILLE
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State | AL
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Zip | 35565-1552
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Country | US
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Telephone | 205-486-4321
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Fax | 205-486-4341
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIST
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Name | JAMES HUNTER MANASCO
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Credential | O.D.
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Telephone | 205-486-4321
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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 | S344TA053
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License Number State | AL
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