Individual
MINA MANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
PO BOX 6, AUGUSTA, KS 67010-0006
(316) 806-8789
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
48331
KS
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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