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General NPI Number Information
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NPI Number | 1669548111
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Entity Type | Organization
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Legal Business Name | MANIPULATORS INC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 30 ACOMA BLVD S STE 203
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5920
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Country | US
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Telephone | 928-680-9500
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Fax | 928-855-9605
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Provider Business Mailing Address
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Address Line | 340 CYPRESS DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86406-6864
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Country | US
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Telephone | 928-680-9500
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Fax | 928-855-9605
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. DANIEL W TALLEY
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Credential | DC
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Telephone | 928-680-9500
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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 | 7202
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License Number State | AZ
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