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General NPI Number Information
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NPI Number | 1740275163
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Entity Type | Organization
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Legal Business Name | MANN & MANN OPTOMETRISTS PC
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 131 N 3RD ST
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City | TECUMSEH
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State | NE
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Zip | 68450-2491
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Country | US
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Telephone | 402-335-2022
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Fax | 402-335-3168
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Provider Business Mailing Address
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Address Line | PO BOX 99
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City | TECUMSEH
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State | NE
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Zip | 68450-0099
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Country | US
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Telephone | 402-335-2022
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Fax | 402-335-3168
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY V MANN
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Credential | OD
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Telephone | 402-335-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 921
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License Number State | NE
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