Provider Demographics
NPI:1245482140
Name:DISC INSTITUTE PC
Entity type:Organization
Organization Name:DISC INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-219-5324
Mailing Address - Street 1:44250 GARFIELD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-416-3472
Mailing Address - Fax:586-416-4211
Practice Address - Street 1:44250 GARFIELD
Practice Address - Street 2:SUITE 104
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-416-3472
Practice Address - Fax:586-416-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty