Provider Demographics
NPI:1417250440
Name:MANLEY, NEAL JEFFREY (RPH)
Entity Type:Individual
Prefix:MR
First Name:NEAL
Middle Name:JEFFREY
Last Name:MANLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 WLAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0237
Mailing Address - Country:US
Mailing Address - Phone:702-228-4742
Mailing Address - Fax:702-228-3068
Practice Address - Street 1:7530 WLAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0237
Practice Address - Country:US
Practice Address - Phone:702-228-4742
Practice Address - Fax:702-228-3068
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist