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General NPI Number Information
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NPI Number | 1396366332
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Entity Type | Individual
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Provider Name | GRAHAM R MANN JR. DO
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Gender | Male
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 1227 BALTIMORE ST
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City | HANOVER
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State | PA
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Zip | 17331-4406
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Country | US
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Telephone | 717-812-7559
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Fax | 717-632-2422
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax | 717-851-6969
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 89521
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 89521
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | OS023956
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License Number State | PA
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