Individual
DR. AL'TIANA MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1979 MARCUS AVENUE SUITE 206, LAKE SUCCESS, NY 11042
(516) 243-8611
Mailing address
PO BOX 3076, WEST MEMPHIS, AR 72303-3076
(912) 713-6015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
003213
CT
152W00000X
Optometrist
1045
NH
152W00000X
Optometrist
27OA00708500
NJ
152W00000X
Optometrist
Primary
3609
TN
152W00000X
Optometrist
3979-35
WI
152W00000X
Optometrist
4901005570
MI
152W00000X
Optometrist
OPT003489
GA
152W00000X
Optometrist
TUV009456
NY
Other
Enumeration date
06/25/2020
Last updated
06/03/2024
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