Provider Demographics
NPI:1841256864
Name:MANTER, DON R (MHSC, PT, MTC)
Entity type:Individual
Prefix:MR
First Name:DON
Middle Name:R
Last Name:MANTER
Suffix:
Gender:M
Credentials:MHSC, PT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 HIGHLAND PARK PL
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-1132
Mailing Address - Country:US
Mailing Address - Phone:727-732-9752
Mailing Address - Fax:
Practice Address - Street 1:12159 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8678
Practice Address - Country:US
Practice Address - Phone:941-776-5585
Practice Address - Fax:941-776-5655
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist