Individual
MICHELLE MANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 109TH AVE NE, BLAINE, MN 55449-4670
(763) 354-1000
Mailing address
8462 NORWAY ST NW, COON RAPIDS, MN 55433-6065
(763) 318-0641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9305
MN
Other
Enumeration date
01/04/2007
Last updated
03/28/2018
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