Provider Demographics
NPI:1417152539
Name:MANGES, SHERYL L (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:L
Last Name:MANGES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6458 OLD BUNCOMBE RD
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-9073
Mailing Address - Country:US
Mailing Address - Phone:864-610-9723
Mailing Address - Fax:864-610-9984
Practice Address - Street 1:6458 OLD BUNCOMBE RD
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-9073
Practice Address - Country:US
Practice Address - Phone:864-610-9723
Practice Address - Fax:864-610-9984
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor