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General NPI Number Information
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NPI Number | 1245482140
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Entity Type | Organization
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Legal Business Name | DISC INSTITUTE PC
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 44250 GARFIELD SUITE 104
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City | CLINTON TWP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-416-3472
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Fax | 586-416-4211
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Provider Business Mailing Address
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Address Line | 44250 GARFIELD SUITE 104
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City | CLINTON TWP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-416-3472
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Fax | 586-416-4211
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOSEPH MANNELLA
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Credential | D.C.
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Telephone | 586-219-5324
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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 | 2301006924
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License Number State | MI
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