Whalio Doctors

NPI 1174509467

Carol Manning

Practitioner General Practice Physician St Louis Park, MN

Practice location

Address
3850 Park Nicollet Blvd, St Louis Park, MN 55416
Phone
(952) 993-3025
Mailing address
3800 Park Nicollet Blvd Credentialing, St Louis Park, MN 55416-2527

Registered specialties

General Practice Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 24919 (MN)

Registry record

NPI
1174509467
Entity type
Individual
Sex (as registered)
Female
NPI issued
19 Dec 2005
Record last updated
5 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.