Provider Demographics
NPI:1982771614
Name:MCMANUS, CLAIRE A (LIC AC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:A
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SHEFFIELD RD
Mailing Address - Street 2:#3
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1513
Mailing Address - Country:US
Mailing Address - Phone:617-818-5549
Mailing Address - Fax:
Practice Address - Street 1:81 COREY ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-2338
Practice Address - Country:US
Practice Address - Phone:617-818-5549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211077171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist