MEDICARE: DOUGLAS B MANOLAKOS DC

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
1	111N00000X	Chiropractor	CH6359	FL
2	111N00000X	Chiropractor	CHIRO003117	GA

General Provider Information

NPI Number	:	1417956863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS B MANOLAKOS DC

Provider Business Mailing Address
First Line	:	1000 LINTON BLVD
Second Line	:	SUITE A7
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-1123
Country	:	US
Telephone Number	:	561-272-0388
Fax Number	:	561-272-0498

Provider Business Practice Location Address
First Line	:	1000 LINTON BLVD
Second Line	:	SUITE A7
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-1123
Country	:	US
Telephone Number	:	561-272-0388
Fax Number	:	561-272-0498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/03/2011

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Directions to “ DOUGLAS B MANOLAKOS DC” Practice Location

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