Provider Demographics
NPI:1952659716
Name:MANOVILL CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:MANOVILL CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MANOVILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-799-2737
Mailing Address - Street 1:2467 ENTERPRISE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1724
Mailing Address - Country:US
Mailing Address - Phone:727-799-2737
Mailing Address - Fax:727-791-0973
Practice Address - Street 1:2467 ENTERPRISE RD
Practice Address - Street 2:SUITE D
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1724
Practice Address - Country:US
Practice Address - Phone:727-799-2737
Practice Address - Fax:727-791-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty