Provider Demographics
NPI:1346206497
Name:MANZELLI, SHERRY MOLINAR (MS, LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:MOLINAR
Last Name:MANZELLI
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 PARR DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1325
Mailing Address - Country:US
Mailing Address - Phone:317-253-5655
Mailing Address - Fax:317-415-5748
Practice Address - Street 1:8227 NORTHWEST BLVD
Practice Address - Street 2:STE. 160
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1387
Practice Address - Country:US
Practice Address - Phone:317-425-5747
Practice Address - Fax:317-415-5748
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000432A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer