Organization Name: | MANNON MOTION, LTD. CO. |
NPI Number: | 1326155250 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KORI R MANNON (OWNER) |
Mailing Address: | 106 Warm Springs Blvd Elephant Butte |
State: | NM US |
Postal Code: | 87935 |
Phone Number: | 5057445187 |
Fax Number: | 5057444911 |
NPI Enumeration Date: | 08/24/2006 |
NPI Last Update Date: | 10/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | #2194 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |