Provider Demographics
NPI:1164589511
Name:MANHART, PATSY JEANNE (BCHIS)
Entity Type:Individual
Prefix:MRS
First Name:PATSY
Middle Name:JEANNE
Last Name:MANHART
Suffix:
Gender:F
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42382 BOB HOPE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4469
Mailing Address - Country:US
Mailing Address - Phone:760-341-9619
Mailing Address - Fax:760-776-5861
Practice Address - Street 1:42382 BOB HOPE DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4469
Practice Address - Country:US
Practice Address - Phone:760-341-9619
Practice Address - Fax:760-776-5861
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA860174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist