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Individual

KENNETH W. MANUELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
500 5TH ST, BROOKINGS, OR 97415-9702
(541) 412-2000
(541) 412-2081
Mailing address
500 5TH ST, BROOKINGS, OR 97415-9702
(541) 412-2000
(541) 412-2081

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19106
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1083656367
CURRY MEDICAL CENTER'S NPI
OR
01
1487696985
CURRY GENERAL HOSPITAL'S NPI
OR
05
151326
OR
Enumeration date
06/08/2006
Last updated
10/20/2020
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