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General NPI Number Information
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NPI Number | 1437361078
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Entity Type | Individual
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Provider Name | KRISTY PIERCE MANN PT
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4605 MACCORKLE AVE SW
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25309-1311
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Country | US
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Telephone | 304-766-3600
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Fax | 304-766-3793
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Provider Business Mailing Address
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Address Line | 101 BEECHVALE DR
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City | CHARLESTON
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State | WV
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Zip | 25313-1800
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Country | US
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Telephone | 304-776-8515
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1211
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License Number State | WV
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