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General NPI Number Information
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NPI Number | 1235076555
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Entity Type | Organization
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Legal Business Name | SKYLINE CHIROPRACTIC
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 1412 YELM AVE E STE C101
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City | YELM
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State | WA
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Zip | 98597-8328
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Country | US
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Telephone | 850-420-7643
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Fax | 877-537-1160
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Provider Business Mailing Address
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Address Line | 1412 YELM AVE E STE C101
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City | YELM
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State | WA
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Zip | 98597-8328
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Country | US
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Telephone | 850-420-7643
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Fax | 877-537-1160
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS MANZANARES
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Credential | DC
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Telephone | 850-420-7643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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