Provider Demographics
NPI:1821230962
Name:MANN, MAUREEN KANE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:KANE
Last Name:MANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 LAUTENBERG LN
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-8636
Mailing Address - Country:US
Mailing Address - Phone:919-491-7180
Mailing Address - Fax:
Practice Address - Street 1:2820 LAUTENBERG LN
Practice Address - Street 2:
Practice Address - City:WILLOW SPRING
Practice Address - State:NC
Practice Address - Zip Code:27592-8636
Practice Address - Country:US
Practice Address - Phone:919-491-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist