Individual
GAVIN MICHAEL MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1103 W BURNSVILLE PKWY STE 120, BURNSVILLE, MN 55337-5829
(952) 300-1461
Mailing address
200 E BURNSVILLE PKWY UNIT 1214, BURNSVILLE, MN 55337-6674
(320) 444-8304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12825
MN
Other
Enumeration date
08/02/2023
Last updated
08/31/2023
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