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General NPI Number Information
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NPI Number | 1811667272
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Entity Type | Individual
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Provider Name | WHITNEY MANUEL
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 250 W 57TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2535
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Country | US
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Telephone | 219-629-6876
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Fax |
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Provider Business Mailing Address
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Address Line | 10820 PARK PL
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City | SAINT JOHN
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State | IN
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Zip | 46373-8630
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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 |
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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 | 2160548
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 06005321A
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License Number State | IN
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