Individual
MANOGNA PUCHHALAPALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 BILL CARRUTH PKWY STE 3100, HIRAM, GA 30141-3819
(678) 363-1940
Mailing address
1833 HEIRLOOM CT, MARIETTA, GA 30066-1636
(773) 680-7669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
02/19/2025
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