Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DN013349 | GA |
Y | 1223G0001X | General Practice | DN013349 | GA |
Y | 213EG0000X | General Practice | DN013349 | GA |
NPI | 1326267576 |
---|---|
Provider Name | Dr. Jarrett Manning |
First Address | Smyrna, GA 30080-2065 |
Second Address | Smyrna, GA 30080-2065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 24/03/2021 |