Provider Demographics
NPI:1700242658
Name:MCMANUS, JESSICA LEIGH (ATC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEIGH
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 KIRK ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:AL
Mailing Address - Zip Code:36274-1635
Mailing Address - Country:US
Mailing Address - Phone:334-863-4404
Mailing Address - Fax:
Practice Address - Street 1:3800 RIVER RUN DR STE 102
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35243-4719
Practice Address - Country:US
Practice Address - Phone:205-353-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18622255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer