Organization
MANUBAY MEDICAL CLINIC MD INC
Active
Other names
TERESITA I. MANUBAY M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESITA I MANUBAY M.D. (OWNER)
(573) 888-9823
Entity
Organization
Contact information
Practice address
1312 1ST ST, KENNETT, MO 63857-2526
(573) 888-1224
(573) 888-9823
Mailing address
1312 1ST ST, KENNETT, MO 63857-2526
(573) 888-1224
(573) 888-9823
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MOMDR6794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107995001
—
AR
05
—
200363505
—
MO
Enumeration date
11/02/2010
Last updated
11/08/2010
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