Provider Demographics
NPI:1588950174
Name:MANNING, BRYNNE ALISON (DPT)
Entity type:Individual
Prefix:
First Name:BRYNNE
Middle Name:ALISON
Last Name:MANNING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRYNNE
Other - Middle Name:ALISON
Other - Last Name:KEELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:4897 STATE ROUTE 209
Practice Address - Street 2:
Practice Address - City:ELIZABETHVILLE
Practice Address - State:PA
Practice Address - Zip Code:17023-8455
Practice Address - Country:US
Practice Address - Phone:717-362-8810
Practice Address - Fax:717-362-3340
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT002818225100000X
PAPT021333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102631781Medicaid