Individual
DR. MARK A MANARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2421 W EDGEWOOD DR, STE A, JEFFERSON CITY, MO 65109-5844
(573) 636-2103
Mailing address
2421 W EDGEWOOD DR, STE A, JEFFERSON CITY, MO 65109-5844
(573) 636-2103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO3364
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318903804
—
MO
Enumeration date
11/03/2005
Last updated
01/30/2013
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