Provider Demographics
NPI:1841512654
Name:MANN & HENRY PODIATRY SERVICES LLC
Entity type:Organization
Organization Name:MANN & HENRY PODIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-334-1825
Mailing Address - Street 1:525 W MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2418
Mailing Address - Country:US
Mailing Address - Phone:717-334-1825
Mailing Address - Fax:
Practice Address - Street 1:525 W MIDDLE ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2418
Practice Address - Country:US
Practice Address - Phone:717-334-1825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANN & HENRY PODIATRY SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-20
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5362690002Medicare NSC