Provider Demographics
NPI:1891825428
Name:MANNING, RHONDA ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ANN
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:PO BOX 220576
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-2576
Mailing Address - Country:US
Mailing Address - Phone:915-587-6226
Mailing Address - Fax:915-845-1165
Practice Address - Street 1:7609 LUZ DE LUMBRE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8481
Practice Address - Country:US
Practice Address - Phone:915-587-6226
Practice Address - Fax:915-845-1165
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129393225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171696101Medicaid
TX171696102Medicaid