Provider Demographics
NPI:1417789116
Name:OFFSHIFT INC
Entity type:Organization
Organization Name:OFFSHIFT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MANERA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:618-979-4074
Mailing Address - Street 1:513 PARKLAND PLACE DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-7557
Mailing Address - Country:US
Mailing Address - Phone:618-979-4074
Mailing Address - Fax:
Practice Address - Street 1:513 PARKLAND PLACE DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7557
Practice Address - Country:US
Practice Address - Phone:618-979-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty