Manuel Tissura

NPI 1295981165 · on the registry since 2008

Practice

Address: 2771 Lawrenceville Hwy
Suite 201
Decatur, GA 30033
Phone: (678) 990-8034
Fax: (770) 934-7176
Organisation at this address: Backstrong Non-Surgical Rehab Clinic
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: Endodontics
1223E0200X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-08-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia