Provider Demographics
NPI:1093848186
Name:MANNEWITZ, WILLIAM BRUCE II (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:MANNEWITZ
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1614 APACHE DR
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-5112
Mailing Address - Country:US
Mailing Address - Phone:806-244-0940
Mailing Address - Fax:806-244-0017
Practice Address - Street 1:115 E TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-4319
Practice Address - Country:US
Practice Address - Phone:806-244-0015
Practice Address - Fax:806-244-0017
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1147133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist