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General NPI Number Information
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NPI Number | 1407882384
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Entity Type | Individual
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Provider Name | DAVID W. MANSKY D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 1127 W STATE ST SUITE B
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City | HASTINGS
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State | MI
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Zip | 49058-7754
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Country | US
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Telephone | 269-945-2222
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Fax | 269-948-2223
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Provider Business Mailing Address
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Address Line | 4310 LEONARD ST NW SUITE 103
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City | WALKER
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State | MI
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Zip | 49534-8447
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Country | US
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Telephone | 616-453-6329
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Fax | 616-453-1725
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901001735
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License Number State | MI
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