Individual
MR. RAYMOND MANUEL MANZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPS PT
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 241-9099
Mailing address
5100 HIGHBRIDGE ST APT 29E, FAYETTEVILLE, NY 13066-2443
(315) 247-4230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
020626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206261
PT
NY
Enumeration date
11/16/2007
Last updated
08/15/2022
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