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General NPI Number Information
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NPI Number | 1437928785
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Entity Type | Individual
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Provider Name | ADRIANA M MCMANUS CMT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2023
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 5740 WINDMILL WAY STE 8
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City | CARMICHAEL
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State | CA
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Zip | 95608-1379
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Country | US
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Telephone | 916-467-8091
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Fax |
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Provider Business Mailing Address
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Address Line | 8124 RATTAN WAY
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-1031
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Country | US
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Telephone | 191-621-6158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | SPB12022-00531
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License Number State | CA
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