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NPI Code Detail

MEDICARE: MISS NERIMA MANGO D.C

MEDICARE: MISS NERIMA MANGO D.C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor009571GA

General Provider Information

NPI Number : 1073060687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS NERIMA MANGO D.C
Provider Business Mailing Address
First Line : 1706 BARRINGTON OVERLOOK
Second Line :
City : MARIETTA
State : GA
Zip : 30066
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1373 CLEVELAND AVE
Second Line :
City : ATLANTA
State : GA
Zip : 30344-3423
Country : US
Telephone Number : 470-355-8974
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2016
Last Update Date : 09/01/2016

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Directions to “ MISS NERIMA MANGO D.C” Practice Location

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