MEDICARE: MANISHA PATEL DC, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	4232	OK

General Provider Information

NPI Number	:	1053854190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANISHA PATEL DC, PLLC

Provider Business Mailing Address
First Line	:	3209 S BROADWAY
Second Line	:	STE 217
City	:	EDMOND
State	:	OK
Zip	:	73013-4061
Country	:	US
Telephone Number	:	405-726-8330
Fax Number	:

Provider Business Practice Location Address
First Line	:	3209 S BROADWAY
Second Line	:	STE 217
City	:	EDMOND
State	:	OK
Zip	:	73013-4061
Country	:	US
Telephone Number	:	405-726-8330
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MANISHA PATEL
Credential	:	DC
Telephone Number	:	405-519-5011

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

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