Provider Demographics
NPI:1114390978
Name:MANOLIS, ELAINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:
Last Name:MANOLIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELAINA
Other - Middle Name:
Other - Last Name:KAPURANIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:125 FOREST PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:02184
Mailing Address - Country:US
Mailing Address - Phone:781-807-6139
Mailing Address - Fax:
Practice Address - Street 1:1095 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4718
Practice Address - Country:US
Practice Address - Phone:978-955-9448
Practice Address - Fax:978-955-9449
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic