Provider Demographics
NPI:1568684447
Name:MANZUK, SHARON SATOE (PT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:SATOE
Last Name:MANZUK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:SATOE
Other - Last Name:TOTTORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4402 VANDEVER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3316
Mailing Address - Country:US
Mailing Address - Phone:619-516-7221
Mailing Address - Fax:
Practice Address - Street 1:4402 VANDEVER AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-3316
Practice Address - Country:US
Practice Address - Phone:619-516-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT251012251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics