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Organization
MANESS HOLDING COMPANY LLC
Active
Organization
MANESS HOLDING COMPANY LLC
Active
Other names
Back to Life
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GOVINDA MANESS MSOT (OWNER/PROVIDER)
(561) 802-8074
Entity
Organization
Contact information
Practice address
4413 NW ALSACE AVE, PORT SAINT LUCIE, FL 34983
(561) 802-8074
Mailing address
1729 NW SAINT LUCIE WEST BLVD # 1097, PORT SAINT LUCIE, FL 34986-2501
(561) 802-8074
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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