Provider Demographics
NPI:1659338192
Name:MANNING, MONICA H (PT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:H
Last Name:MANNING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:E
Other - Last Name:HLADKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 COBBLESTONE LANE
Mailing Address - Street 2:COURAGE BURNSVILLE
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337
Mailing Address - Country:US
Mailing Address - Phone:952-898-5700
Mailing Address - Fax:952-898-5757
Practice Address - Street 1:100 COBBLESTONE LANE
Practice Address - Street 2:COURAGE BURNSVILLE
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337
Practice Address - Country:US
Practice Address - Phone:952-898-5700
Practice Address - Fax:952-898-5757
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27692251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP41177OtherHEALTH PARTNERS
6402792OtherMEDICA
MN9V744MAOtherBCBS MINNESOTA