Provider Demographics
NPI:1356006613
Name:MANZANO CHIROPRACTIC INC
Entity Type:Organization
Organization Name:MANZANO CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHODEL
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MANZANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ATC
Authorized Official - Phone:661-753-3090
Mailing Address - Street 1:23949 RUSTICO CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1559
Mailing Address - Country:US
Mailing Address - Phone:661-877-0429
Mailing Address - Fax:
Practice Address - Street 1:25000 AVENUE STANFORD STE 161
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-4594
Practice Address - Country:US
Practice Address - Phone:661-753-3090
Practice Address - Fax:855-563-2545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty