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NPI Code Detail

MEDICARE: LARRY MANN DO

MEDICARE: LARRY MANN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101021624MI

General Provider Information

NPI Number : 1497133714
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY MANN DO
Provider Business Mailing Address
First Line : 601 JOHN ST # 42
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-5341
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 WATKINS RD
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-8604
Country : US
Telephone Number : 269-245-5430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2015
Last Update Date : 03/08/2023

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Directions to “ LARRY MANN DO” Practice Location

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