Individual
MRS. JULIE MARIE MANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1454
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025389600
—
NE
01
—
1700112729
SIOUX VALLEY HEALTH PLAN
SD
05
—
5831260
—
SD
01
—
9288136
DAKOTA CARE
SD
Enumeration date
10/27/2009
Last updated
06/16/2011
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