Individual
PEYTON MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
640 WRIGHT AVE, BOWLING GREEN, KY 42103-1623
(866) 755-4258
Mailing address
1203 CHESTNUT ST, BOWLING GREEN, KY 42101-2681
(859) 338-6661
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KY
Other
Enumeration date
08/17/2022
Last updated
08/17/2022
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