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Organization
THE MANIS GROUP
Active
Organization
THE MANIS GROUP
Active
Other names
Performance Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW BLAKE MANIS PH.D. (CHEIF EXECUTIVE OFFICER)
(214) 230-1621
Entity
Organization
Contact information
Practice address
1601 N HIGHWAY 77, WAXAHACHIE, TX 75165-7812
(214) 230-1621
(972) 935-0930
Mailing address
119 CHESTERFIELD CIR, WAXAHACHIE, TX 75165-6362
(214) 230-1621
(972) 935-0930
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
TX
111N00000X
Chiropractor
Primary
6118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104817899
NPPES, NPI
—
01
—
1215360490
NPPES, NPI
—
Enumeration date
09/10/2013
Last updated
09/10/2013
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