Individual
MANIOS LIBERAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9105 WALDEN BROOK DR, LITHONIA, GA 30038-1283
(404) 492-0974
Mailing address
9105 WALDEN BROOK DR, LITHONIA, GA 30038-1283
(404) 492-0974
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT011439
GA
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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