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NPI Code Detail

MEDICARE: COLE K MANN

MEDICARE: COLE K MANN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1679352488
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLE K MANN
Provider Business Mailing Address
First Line : 464099 STATE ROAD 200 STE 2
Second Line :
City : YULEE
State : FL
Zip : 32097-6460
Country : US
Telephone Number : 904-875-4461
Fax Number :
Provider Business Practice Location Address
First Line : 464099 STATE ROAD 200 STE 2
Second Line :
City : YULEE
State : FL
Zip : 32097-6460
Country : US
Telephone Number : 904-875-4461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2023
Last Update Date : 09/22/2023

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Directions to “ COLE K MANN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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