Provider Demographics
NPI:1699112953
Name:MANLEY, STEVEN CLINT (PA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CLINT
Last Name:MANLEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1930 BRANNAN RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4310
Mailing Address - Country:US
Mailing Address - Phone:678-284-4040
Mailing Address - Fax:678-284-4076
Practice Address - Street 1:1357 HEMBREE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5722
Practice Address - Country:US
Practice Address - Phone:770-475-7550
Practice Address - Fax:770-343-9080
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2020-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAAPPLIED FOR363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical