Individual
SHAWN LEACH-MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2510 HALLIE MILL RD, COLLEGE PARK, GA 30349-4927
(770) 997-3857
Mailing address
2510 HALLIE MILL RD, COLLEGE PARK, GA 30349-4927
(770) 997-3857
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
01/23/2008
Last updated
01/23/2008
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