Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC4480 | TX |
NPI | 1619033305 |
---|---|
Provider Name | Dr. Jeffery Earl Manley |
First Address | Arlington, TX 76017-1596 |
Second Address | Arlington, TX 76017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001349201 | (05) | TX |
601766 | (02) | TX |
T14576 | (02) | TX |