Organization
MARK A. MANARY, O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MANARY O.D. (OWNER)
(573) 489-2499
Entity
Organization
Contact information
Practice address
415 CONLEY RD, COLUMBIA, MO 65201-6468
(573) 499-1945
Mailing address
3505 BRAY AVE, COLUMBIA, MO 65203-0794
(573) 489-2499
(573) 636-2103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO3364
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318903838
—
MO
Enumeration date
10/06/2006
Last updated
11/04/2019
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