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General NPI Number Information
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NPI Number | 1770754293
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Entity Type | Organization
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Legal Business Name | THAD R MANNING D.O., PSC
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 9613 MILLARD HWY
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City | PIKEVILLE
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State | KY
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Zip | 41501-8162
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Country | US
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Telephone | 606-754-7089
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Fax |
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Provider Business Mailing Address
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Address Line | 9613 MILLARD HWY
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City | PIKEVILLE
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State | KY
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Zip | 41501-8162
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Country | US
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Telephone | 606-754-7089
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. THAD R MANNING
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Credential | D.O.,
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Telephone | 606-754-7089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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