Provider Demographics
NPI:1871607952
Name:MANTI, FRANCESCA (MS PT)
Entity type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:
Last Name:MANTI
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61438 DAVIS LAKE LOP
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702
Mailing Address - Country:US
Mailing Address - Phone:541-350-0757
Mailing Address - Fax:
Practice Address - Street 1:404 NE PENN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4264
Practice Address - Country:US
Practice Address - Phone:541-318-7041
Practice Address - Fax:541-388-3711
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORJ-0471-01OtherPACIFIC SOURCE
OR228892Medicaid
OR804888000OtherBC/BS
ORR114226Medicare PIN