Provider Demographics
NPI:1134430598
Name:MANNING, JOSHUA NATHANIEL (PT)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:NATHANIEL
Last Name:MANNING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 PARK PL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-9806
Mailing Address - Country:US
Mailing Address - Phone:717-477-8030
Mailing Address - Fax:717-477-8040
Practice Address - Street 1:20 PARK PL
Practice Address - Street 2:SUITE 2
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-9806
Practice Address - Country:US
Practice Address - Phone:717-477-8030
Practice Address - Fax:717-477-8040
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026272880001Medicaid
PA186459V9XMedicare PIN