Provider Demographics
NPI:1184848442
Name:MANNING, JEFFREY I (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:I
Last Name:MANNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 MCKINNEY AVE.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-8544
Mailing Address - Country:US
Mailing Address - Phone:214-720-2225
Mailing Address - Fax:214-720-2288
Practice Address - Street 1:2702 MCKINNEY AVE.
Practice Address - Street 2:SUITE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-8544
Practice Address - Country:US
Practice Address - Phone:214-720-2225
Practice Address - Fax:214-720-2288
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7027111N00000X
NYX008854-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605888OtherBLUE CROSS BLUE SHIELD
TX609844Medicare ID - Type Unspecified