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General NPI Number Information
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NPI Number | 1669715405
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Entity Type | Individual
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Provider Name | BRIAN ROBERT MCMANUS D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 928 DIXIE HWY
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City | ROSSFORD
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State | OH
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Zip | 43460-1333
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Country | US
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Telephone | 419-666-5299
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Fax |
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Provider Business Mailing Address
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Address Line | 928 DIXIE HWY
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City | ROSSFORD
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State | OH
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Zip | 43460-1333
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Country | US
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Telephone | 419-666-5299
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36003774
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License Number State | OH
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