Provider Demographics
NPI:1760932768
Name:MANARD, KENNETH JR
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:MANARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 INWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-1908
Mailing Address - Country:US
Mailing Address - Phone:504-344-1108
Mailing Address - Fax:
Practice Address - Street 1:2439 MANHATTAN BLVD STE 301
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058
Practice Address - Country:US
Practice Address - Phone:504-309-4628
Practice Address - Fax:504-309-4647
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator