Mannik, John A

Mannik, John A is an individual health care provider with primary practice located at 1088 S Bailey Ave Suite B, South Haven MI 49090-9728. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mannik, John A can be contacted via phone (269) 637-1442.

Contact Information

Primary practice address
1088 S Bailey Ave Suite B South Haven MI 49090-9728
Fax: (269) 637-3801
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003263 Michigan

Profile Details

NPI number 1003814500
LBN Legal business name Mannik, John A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Feb 19th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003814500 NPPES
Michigan MEDICAID 3238512

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