Individual
LISA NICOLE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1285 BEACON ST, BROOKLINE, MA 02446-5237
(617) 751-6205
Mailing address
440 FOLEY ST, SOMERVILLE, MA 02145-1213
(857) 282-0777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6689
MA
Other
Enumeration date
08/31/2018
Last updated
10/18/2022
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