Organization
MANESS HOLDING COMPANY LLC
Active
Other names
Back to Life
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK GOVINDA MANESS MSOT (OWNER/PROVIDER)
(561) 802-8074
Entity
Organization
Contact information
Practice address
4413 NW ALSACE AVE, PORT SAINT LUCIE, FL 34983
(561) 802-8074
Mailing address
1729 NW SAINT LUCIE WEST BLVD # 1097, PORT SAINT LUCIE, FL 34986-2501
(561) 802-8074
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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