MEDICARE: CHRYS A. MANOS, OD, LTD.

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
1	152W00000X	Optometrist	369	NV

General Provider Information

NPI Number	:	1871824904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRYS A. MANOS, OD, LTD.

Provider Business Mailing Address
First Line	:	500 E WINDMILL LN
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1843
Country	:	US
Telephone Number	:	702-437-2889
Fax Number	:	702-437-5196

Provider Business Practice Location Address
First Line	:	500 E WINDMILL LN
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1843
Country	:	US
Telephone Number	:	702-437-2889
Fax Number	:	702-437-5196

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. CHRYS AVERY MANOS
Credential	:	O.D.
Telephone Number	:	702-437-2889

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	02/29/2012

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