Individual
MARIE JOYCE HERRERA MANAOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 MEELER CIR, BOGART, GA 30622-6835
(213) 359-7786
Mailing address
224 MEELER CIR, BOGART, GA 30622-6835
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011862
GA
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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