Provider Demographics
NPI:1659306801
Name:MANNING, MAURINE EVE (PT)
Entity Type:Individual
Prefix:MS
First Name:MAURINE
Middle Name:EVE
Last Name:MANNING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 MASON LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3025
Mailing Address - Country:US
Mailing Address - Phone:916-524-0854
Mailing Address - Fax:
Practice Address - Street 1:2880 SUNRISE BLVD STE 218
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6101
Practice Address - Country:US
Practice Address - Phone:916-852-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist