Individual
ZACH MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 LINCOLN DR, LAWRENCEVILLE, IL 62439-1841
(812) 890-2955
Mailing address
301 LINCOLN DR, LAWRENCEVILLE, IL 62439-1841
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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