Most Relevant Information
Provider Data
| NPI Number: | 1003814500 |
| Provider Name: | JOHN A MANNIK O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 4901003263 |
Most Important Dates
| Enumeration Date: | 07/08/2005 |
| Last Updated: | 02/19/2015 |
Provider Practice Location
1088 S BAILEY AVE
SUITE B
SOUTH HAVEN
MI
490909728
Practice Location Phone/Fax
| Phone: | 2696371442 |
| Fax: | 2696373801 |
Provider Mailing Location
1088 S BAILEY AVE
SUITE B
SOUTH HAVEN
MI
490909728
Provider Mailing Phone/Fax
| Phone: | 2696371442 |
| Fax: | 2696373801 |