Organization
MANZER FAMILY MEDICINE, LLC
Active
Other names
Jonathan Manzer
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LYLE MANZER M.D. (PHYSICIAN)
(417) 358-4811
Entity
Organization
Contact information
Practice address
3071 S GRAND AVE, CARTHAGE, MO 64836-7851
(417) 358-4811
Mailing address
3071 S GRAND AVE, CARTHAGE, MO 64836-7851
(417) 358-4811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004001464
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209288406
—
MO
Enumeration date
02/28/2007
Last updated
11/25/2013
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