Healthcare Provider Details

I. General information

NPI: 1518782580
Provider Name (Legal Business Name): HANNAH MANIK PHYSICAL THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 PALEN AVE
NEWPORT NEWS VA
23601-4016
US

IV. Provider business mailing address

310 PALEN AVE
NEWPORT NEWS VA
23601-4016
US

V. Phone/Fax

Practice location:
  • Phone: 757-561-0414
  • Fax: 804-707-4157
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HANNAH MANIK
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 919-428-0229