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General NPI Number Information
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NPI Number | 1710808076
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Entity Type | Individual
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Provider Name | SEAN THOMAS MCMANUS
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Gender | Male
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 6965 CUMBERLAND GAP PKWY
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City | HARROGATE
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State | TN
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Zip | 37752-8231
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Country | US
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Telephone | 423-869-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 VETERANS PKWY APT 1225
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City | COLUMBUS
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State | GA
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Zip | 31909-2458
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Country | US
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Telephone | 706-580-9324
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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