Manning, Jerry Wayne
Manning, Jerry Wayne is an individual health care provider with primary practice located at 3016 W Main St Ste 200 , Russellville AR 72801-2453. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Manning, Jerry Wayne can be contacted via phone (479) 967-9657.Contact Information
Primary practice address
3016 W Main St Ste 200
Russellville AR 72801-2453
Phone: (479) 967-9657
Fax: (479) 967-9658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 04847R | Louisiana |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT2457 | Arkansas |
Profile Details
| NPI number | 1043207525 |
|---|---|
| LBN Legal business name | Manning, Jerry Wayne |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Sep 19th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043207525 | NPPES |
| Louisiana | MEDICAID | 1139955 |
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