Provider Demographics
NPI:1518113109
Name:MANARD, ANDREW PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PAUL
Last Name:MANARD
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 1:6201 VETERANS PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-6211
Mailing Address - Country:US
Mailing Address - Phone:706-323-0523
Mailing Address - Fax:706-221-1850
Practice Address - Street 1:6201 VETERANS PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6211
Practice Address - Country:US
Practice Address - Phone:706-323-0523
Practice Address - Fax:706-221-1850
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO01660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV07367Medicare UPIN
GA35ZCJLHMedicare PIN