Provider Demographics
NPI:1831465731
Name:GREGORY C MANOS
Entity Type:Organization
Organization Name:GREGORY C MANOS
Other - Org Name:INJURY AND ACCIDENT CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-408-4900
Mailing Address - Street 1:5151 N ORACLE RD STE 129
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3757
Mailing Address - Country:US
Mailing Address - Phone:520-408-4900
Mailing Address - Fax:520-408-6903
Practice Address - Street 1:5151 N ORACLE RD STE 129
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3757
Practice Address - Country:US
Practice Address - Phone:520-408-4900
Practice Address - Fax:520-408-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8051261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center