Provider Demographics
NPI:1952732562
Name:MCMANAMAN, JON (DC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:MCMANAMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W PASEWALK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5604
Mailing Address - Country:US
Mailing Address - Phone:402-371-4673
Mailing Address - Fax:
Practice Address - Street 1:1800 W PASEWALK AVE STE 102
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5604
Practice Address - Country:US
Practice Address - Phone:402-371-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor