Provider Demographics
NPI:1801053624
Name:CHARNES, MANINA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:MANINA
Middle Name:MARIE
Last Name:CHARNES
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 1:7940 ZIONSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268
Mailing Address - Country:US
Mailing Address - Phone:317-876-9125
Mailing Address - Fax:
Practice Address - Street 1:7841 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4545
Practice Address - Country:US
Practice Address - Phone:812-401-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05000765A225100000X
KY000730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist