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General NPI Number Information
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NPI Number | 1336457407
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Entity Type | Organization
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Legal Business Name | MANNING CHIROPRACTIC
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 1055 PINEY FOREST RD SUITE A
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City | DANVILLE
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State | VA
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Zip | 24540-1531
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Country | US
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Telephone | 434-836-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 PINEY FOREST RD SUITE A
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City | DANVILLE
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State | VA
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Zip | 24540-1531
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Country | US
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Telephone | 434-836-2905
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JERRY RAY MANNING JR.
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Credential | D.C.
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Telephone | 434-836-2905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556602
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License Number State | VA
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