Individual
MR. RICHARD ANTHONY MANN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
901 LAFAYETTE AVE, CAYCE, SC 29033-3224
(803) 791-3963
(803) 429-2134
Mailing address
PO BOX 485, COLUMBIA, SC 29202-0485
(803) 898-8405
(808) 898-8526
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
899
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4350
—
SC
Enumeration date
07/17/2006
Last updated
05/16/2013
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