Individual
DR. JERRY RAY MANNING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1055 PINEY FOREST RD, SUITE A, DANVILLE, VA 24540-4154
(434) 836-2905
Mailing address
4705 CLYDE MORRIS BLVD, PORT ORANGE, FL 32129-4103
(563) 884-5810
(563) 884-5470
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104556602
VA
111N00000X
Chiropractor
Primary
CH13241
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881864569
—
VA
01
—
C05545
GROUP PTAN
—
Enumeration date
03/10/2008
Last updated
01/15/2021
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