Provider Demographics
NPI:1477588473
Name:MANISCALCO, STEVEN J (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:MANISCALCO
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SATARA DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2037
Mailing Address - Country:US
Mailing Address - Phone:910-795-7471
Mailing Address - Fax:
Practice Address - Street 1:3822 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6715
Practice Address - Country:US
Practice Address - Phone:910-313-3275
Practice Address - Fax:910-313-3276
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3293111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician