Individual
DR. JUSTIN THOMAS MANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
535 9TH ST, FLORENCE, OR 97439
(541) 997-3331
Mailing address
PO BOX 277, FLORENCE, OR 97439-0010
(541) 997-3331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3223ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006330
—
OR
01
—
139325
PTAN
OR
01
—
R0000WCYBX
GROUP PTAN
OR
Enumeration date
07/05/2007
Last updated
04/25/2008
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