Individual
ERIC KEITH MANLEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1129 LE CONTE DR, RIVERSIDE, CA 92507-0606
(951) 640-9725
Mailing address
1129 LE CONTE DR, RIVERSIDE, CA 92507-0606
(951) 640-9725
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/31/2022
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