Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2010 | KS |
NPI | 1013398700 |
---|---|
Provider Name | Dr. Jason Manes |
First Address | Topeka, KS 66604-0365 |
Second Address | Topeka, KS 66604-3340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 18/06/2015 |