Provider Demographics
NPI:1508455544
Name:MANGAS, DANIELLE (DC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MANGAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:TRENKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:933 ELIDA AVE
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-1785
Mailing Address - Country:US
Mailing Address - Phone:419-692-9050
Mailing Address - Fax:419-692-9060
Practice Address - Street 1:933 ELIDA AVE
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-1785
Practice Address - Country:US
Practice Address - Phone:419-692-9050
Practice Address - Fax:419-692-9060
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor