# JARED C MANNELLO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164990933
- **Authorized official:** JARED C MANNELLO PT DPT OCS (SOLE MEMBER)
- **Authorized official phone:** (856) 423-7700

## Contact information

- **Practice address:** 450 BAY AVE STE 3, SOMERS POINT, NJ 08244-2656
- **Practice address phone:** (609) 350-6680
- **Mailing address:** 23 N DELSEA DR UNIT B, CLAYTON, NJ 08312-1637
- **Mailing address phone:** (856) 423-7000
- **Mailing address fax:** (856) 423-0823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2018
- **Last updated:** 07/30/2024