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General NPI Number Information
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NPI Number | 1356006613
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Entity Type | Organization
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Legal Business Name | MANZANO CHIROPRACTIC INC
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 25000 AVENUE STANFORD STE 161
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City | SANTA CLARITA
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State | CA
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Zip | 91355-4594
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Country | US
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Telephone | 661-753-3090
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Fax | 855-563-2545
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Provider Business Mailing Address
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Address Line | 23949 RUSTICO CT
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City | SANTA CLARITA
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State | CA
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Zip | 91354-1559
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Country | US
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Telephone | 661-877-0429
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RHODEL MATTHEW MANZANO
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Credential | DC, ATC
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Telephone | 661-753-3090
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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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