Individual
VANESSA MANLOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3051 25TH ST S STE L, FARGO, ND 58103-6102
(701) 234-0766
Mailing address
1902 25TH AVE S, FARGO, ND 58103-5128
(701) 212-8603
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
762
ND
Other
Enumeration date
09/20/2019
Last updated
03/11/2021
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