Individual
CAROL E MANNO
Active
Individual
CAROL E MANNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002387E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018031900007
—
PA
01
—
01803190
MEDICAL ASSISTANCE
PA
Enumeration date
06/26/2006
Last updated
05/12/2008
Update your record
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