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General NPI Number Information
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NPI Number | 1790613172
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Entity Type | Organization
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Legal Business Name | MANITY INC
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 2729 N HAVEN DR
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City | EAGLE
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State | ID
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Zip | 83616-2331
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Country | US
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Telephone | 636-544-7491
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Fax |
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Provider Business Mailing Address
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Address Line | 2729 N HAVEN DR
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City | EAGLE
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State | ID
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Zip | 83616-2331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER SCHOCH
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Credential | MD
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Telephone | 636-544-7491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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