Provider Demographics
NPI:1346352713
Name:MANCHESTER, WILLIAM FREDERICK (DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:MANCHESTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 VILLA ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-6666
Mailing Address - Country:US
Mailing Address - Phone:831-786-9859
Mailing Address - Fax:831-883-8526
Practice Address - Street 1:445 RESERVATION RD
Practice Address - Street 2:SUITE A
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-3301
Practice Address - Country:US
Practice Address - Phone:831-883-8542
Practice Address - Fax:831-883-8526
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist