Individual
VICTORIA GRACE MANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA, ATC
Contact information
Practice address
940 2ND STREET, PORTSMOUTH, OH 45662
(304) 654-0262
Mailing address
940 2ND STREET, PORTSMOUTH, OH 45662
(304) 654-0262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003303
OH
Other
Enumeration date
02/22/2010
Last updated
02/23/2010
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