Individual
DOUG MANICCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
Mailing address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN271654
PA
Other
Enumeration date
10/23/2015
Last updated
10/27/2015
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