Individual
DR. MICHAEL D VANMANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
BLDG 1145 STURGIS RD, TWENTYNINE PALMS, CA 92278
(760) 830-2229
Mailing address
56159 NEZ PERCE TRL, YUCCA VALLEY, CA 92284
(720) 217-7950
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
032.0107331
VT
390200000X
Student in an Organized Health Care Education/Training Program
OT012567
PA
Other
Enumeration date
07/11/2008
Last updated
11/07/2014
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