Individual
MR. EDWARD MATTHEW MANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4151
Mailing address
330 N BROAD ST, FOREST, MS 39074-3508
(601) 469-4151
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
1020521
MS
363A00000X
Physician Assistant
Primary
—
MS
Other
Enumeration date
01/23/2023
Last updated
04/26/2023
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