Individual
COURTNEY MANIATIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1192 BUCKHEAD XING, SUITE C, WOODSTOCK, GA 30189-4254
(678) 238-0301
(678) 238-0323
Mailing address
1192 BUCKHEAD XING, SUITE C, WOODSTOCK, GA 30189-4254
(678) 238-0301
(678) 238-0323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
63919
GA
208D00000X
General Practice Physician
63919
GA
Other
Enumeration date
07/02/2007
Last updated
05/19/2011
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