Healthcare Provider Details

I. General information

NPI: 1972714129
Provider Name (Legal Business Name): CHRISTINE MANELLA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

2587 MELINDA DR NE
ATLANTA GA
30345-1918
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-7288
  • Fax:
Mailing address:
  • Phone: 404-450-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004361
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: