Provider Demographics
NPI:1730687435
Name:MANNING, JOHN BOWLER JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BOWLER
Last Name:MANNING
Suffix:JR
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 1:45 STERLING ST STE 5
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1201
Mailing Address - Country:US
Mailing Address - Phone:508-835-8800
Mailing Address - Fax:508-835-3128
Practice Address - Street 1:45 STERLING ST STE 5
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1201
Practice Address - Country:US
Practice Address - Phone:508-835-8800
Practice Address - Fax:508-835-3128
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor