Provider Demographics
NPI:1952571945
Name:KAZANAS, MANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:KAZANAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 CLEVELAND PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5303
Mailing Address - Country:US
Mailing Address - Phone:219-769-1242
Mailing Address - Fax:219-769-1242
Practice Address - Street 1:8045 CLEVELAND PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5303
Practice Address - Country:US
Practice Address - Phone:219-769-1242
Practice Address - Fax:219-769-1242
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN455450Medicare PIN
INU20346Medicare UPIN