Individual
MASHAIL MANZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 MONTREAL RD E, STE 250, TUCKER, GA 30084
(470) 880-2414
(678) 802-2414
Mailing address
1460 MONTREAL RD E, STE 275, TUCKER, GA 30084
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001450
GA
213E00000X
Podiatrist
PR507
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2017
Last updated
11/13/2020
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