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General NPI Number Information
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NPI Number | 1619251964
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Entity Type | Individual
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Provider Name | AARON JOSEPH MANGINO D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 321 EDWIN DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-4542
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Country | US
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Telephone | 253-740-7354
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Fax |
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Provider Business Mailing Address
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Address Line | 1632 JANKE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3420
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Country | US
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Telephone | 253-740-7354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0104556930
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License Number State | VA
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