Organization
SHAWN LEACH-MANLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN LEACH-MANLEY (OWNER)
(770) 997-3857
Entity
Organization
Contact information
Practice address
2510 HALLIE MILL RD, COLLEGE PARK, GA 30349-4927
(770) 997-3857
(770) 997-9489
Mailing address
2510 HALLIE MILL RD, COLLEGE PARK, GA 30349-4927
(770) 997-3857
(770) 997-9489
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00942697A
—
GA
Enumeration date
03/23/2006
Last updated
01/09/2008
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