Provider Demographics
NPI:1487135877
Name:MENNING, AUSTIN
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:MENNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05462-0023
Mailing Address - Country:US
Mailing Address - Phone:180-243-4605
Mailing Address - Fax:
Practice Address - Street 1:3025 CAMELS HUMP RD.
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:VT
Practice Address - Zip Code:05462
Practice Address - Country:US
Practice Address - Phone:802-434-6056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer