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ANTONIO S MANALO MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1609944313

Individual Registrant:
 ANTONIO S MANALO MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
900 CHURCH ST  SPRINGFIELD, CO 81073 US
Tel: 719-523-6221  Fax: 719-523-4290

Contact information for business:
373 E 10TH AVE  SPRINGFIELD, CO 81073 US
Tel: 719-523-6221  Fax: 719-523-4290

Registration Information:
NPI: 1609944313
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CO21312

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
01213123CO05




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