Organization
J.Z. MANN PEDIATRIC THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HORACE MANN (OFFICE MANAGER)
(910) 347-2212
Entity
Organization
Contact information
Practice address
410 NEW BRIDGE ST, SUITE 10-A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Mailing address
410 NEW BRIDGE ST, SUITE 10-A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1951
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135J
BCBSNC PROVIDER NO.
NC
05
—
7210664
—
NC
Enumeration date
10/03/2006
Last updated
08/22/2020
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