Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.012247 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 60945 | WI |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A121073 | CA |
Y | 207YS0123X | Facial Plastic Surgeon | 60945 | WI |
NPI | 1407028459 |
---|---|
Provider Name | Dr. Ryan Michael Manz |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601-5429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 03/11/2017 |