Provider Demographics
NPI:1346205473
Name:MANN, ANDY C (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:C
Last Name:MANN
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 1:619 N BRINDLEE MOUNTAIN PKWY
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-1055
Mailing Address - Country:US
Mailing Address - Phone:256-586-4147
Mailing Address - Fax:256-586-4150
Practice Address - Street 1:619 N BRINDLEE MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1055
Practice Address - Country:US
Practice Address - Phone:256-586-4147
Practice Address - Fax:256-586-4150
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL71292OtherPROVIDER NUMBER
AL1226OtherSTATE LIC. NUMBER
ALU01853Medicare UPIN