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Individual

DR. MARK A. MANCHESKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1250 E. MASON ST., GREEN BAY, WI 54301
(920) 432-3180
(920) 432-2710
Mailing address
1250 E. MASON ST., GREEN BAY, WI 54301
(920) 432-3180
(920) 432-2710

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2315
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38587800
WI
Enumeration date
10/02/2006
Last updated
03/17/2009
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