Individual
MANUEL R PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
544 BLUE MOUNTAIN RISE, CANTON, GA 30114-5713
(718) 310-9851
(718) 310-9851
Mailing address
544 BLUE MOUNTAIN RISE, CANTON, GA 30114-5713
(718) 310-9851
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
009077-1
NY
225200000X
Physical Therapy Assistant
Primary
PTA005366
GA
Other
Enumeration date
06/10/2020
Last updated
08/12/2026
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