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Individual

NICHOLAS TYLER MANNING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5940 MERCHANTS ST, FLORENCE, KY 41042-1158
(859) 835-4886
Mailing address
730 WASHINGTON ST APT 204, COVINGTON, KY 41011-3042

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
133794
KY
225X00000X
Occupational Therapist
OT009146
OH

Other

Enumeration date
04/26/2020
Last updated
04/26/2020
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