Provider Demographics
NPI:1063491868
Name:MANLEY, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:MANLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-3020
Mailing Address - Country:US
Mailing Address - Phone:712-276-0712
Mailing Address - Fax:712-276-0718
Practice Address - Street 1:4716 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-3020
Practice Address - Country:US
Practice Address - Phone:712-276-0712
Practice Address - Fax:712-276-0718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1152777OtherTITLE 19
IA1152777Medicaid
IA49929OtherBLUE SHIELD
IA8996OtherSIOUX VALLEY HEALTH
IA49929OtherBLUE CROSS OF IA
NENE26417OtherBLUE CROSS OF NE
IA8996OtherSIOUX VALLEY HEALTH
IA49929Medicare ID - Type Unspecified