Taylor M. Manivannan, PA-C

NPI #1568832137 in Springfield, Illinois

Provider Information

NPI Number: 1568832137
Entity Type: Individual
Name: Taylor M. Manivannan, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 25, 2015
Last Updated: Dec 3, 2020

Practice Location

Address: 2200 WABASH AVE
City: Springfield
State: Illinois
ZIP Code: 62704-5352
Phone: (217) 528-7541

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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