Healthcare Provider Details

I. General information

NPI: 1891070140
Provider Name (Legal Business Name): CORTNEY LANGFORD MANIX D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 COOLIDGE HWY
GUILFORD VT
05301-8015
US

IV. Provider business mailing address

PO BOX 8262
BRATTLEBORO VT
05304-8262
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-8335
  • Fax: 802-257-0993
Mailing address:
  • Phone: 802-490-2056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006.0080209
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: