Individual
MR. JEFFREY DWAIN MANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
933 SANDY GLEN LN, BURLEY, ID 83318-3333
(402) 290-4584
Mailing address
933 SANDY GLEN LN, BURLEY, ID 83318-3333
(402) 290-4584
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3761
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
586685
—
IA
01
—
6536
BCBS
NE
Enumeration date
03/31/2006
Last updated
12/22/2016
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