Healthcare Provider Details

I. General information

NPI: 1730413253
Provider Name (Legal Business Name): DIMENSIONAL FAMILY WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11320 KINGSTON PIKE
KNOXVILLE TN
37934-2858
US

IV. Provider business mailing address

2522 TIMBER HIGHLANDS LN
KNOXVILLE TN
37932-2395
US

V. Phone/Fax

Practice location:
  • Phone: 865-567-6237
  • Fax:
Mailing address:
  • Phone: 865-567-6237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTOR MANZO JR.
Title or Position: CEO/PRESIDENT
Credential: DC
Phone: 865-567-6237