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Individual

MARK A MANNETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1903 S HAWTHORNE RD, WINSTON SALEM, NC 27103-3916
(336) 996-7001
(336) 996-0832
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 996-7001
(336) 996-0832

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12384
NC

Other

Enumeration date
10/19/2009
Last updated
10/21/2009
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