Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH10486 | FL |
NPI | 1376816595 |
---|---|
Provider Name | Dr. Isaac Stanford Manning II |
First Address | Orlando, FL 32855-5784 |
Second Address | Orlando, FL 32805-3476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2012 |
Last Update Date | 18/02/2012 |