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Individual

JOHN MANCHIN II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 MAIN ST, FARMINGTON, WV 26571
(304) 825-6554
(304) 825-1371
Mailing address
100 MAIN ST, FARMINGTON, WV 26571
(304) 825-6554
(304) 825-1371

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
702
WV
261QR1300X
Rural Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0034619000
WV
05
0049400000
WV
Enumeration date
08/31/2006
Last updated
06/06/2025
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