Provider Demographics
NPI:1225381379
Name:MANCINI CHIROPRACTIC
Entity Type:Organization
Organization Name:MANCINI CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ARDUICO
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:561-317-1646
Mailing Address - Street 1:15741 CEDAR GROVE LN
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6312
Mailing Address - Country:US
Mailing Address - Phone:561-317-1646
Mailing Address - Fax:
Practice Address - Street 1:15741 CEDAR GROVE LN
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6312
Practice Address - Country:US
Practice Address - Phone:561-317-1646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty