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General NPI Number Information
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NPI Number | 1639423726
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Entity Type | Individual
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Provider Name | HEATHER LYN MANNING P.T.A
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Gender | Female
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 11 CONDITO RD
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City | HINGHAM
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State | MA
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Zip | 02043-1746
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Country | US
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Telephone | 781-749-2057
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Fax |
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Provider Business Mailing Address
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Address Line | 81 GREAT HILL DR
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City | WEYMOUTH
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State | MA
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Zip | 02191-1905
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Country | US
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Telephone | 617-645-3545
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 3987
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License Number State | MA
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