Provider Demographics
NPI:1447969662
Name:MANRY, DANIELLE LOUISE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LOUISE
Last Name:MANRY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3303
Mailing Address - Country:US
Mailing Address - Phone:678-390-6166
Mailing Address - Fax:
Practice Address - Street 1:740 PRINCE AVE STE 8B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5903
Practice Address - Country:US
Practice Address - Phone:762-315-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist