Provider Demographics
NPI:1740831635
Name:MANARAS, JOANNE (LAC, DIPL OM)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MANARAS
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-4903
Mailing Address - Country:US
Mailing Address - Phone:406-399-1743
Mailing Address - Fax:
Practice Address - Street 1:305 3RD AVE STE 209
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3577
Practice Address - Country:US
Practice Address - Phone:406-399-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18249171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist