Individual
BRUCE L MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
665 BRIARTHORN CRESCENT DR., WADSWORTH, OH 44281-7501
(330) 336-9177
(330) 335-3318
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.003551
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0487567
—
OH
Enumeration date
11/08/2006
Last updated
01/18/2021
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