MEDICARE: PAUL MANALOTO D.C.

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	111N00000X	Chiropractor	DC009623	PA
2	111N00000X	Chiropractor	10133	TX

General Provider Information

NPI Number	:	1427299783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL MANALOTO D.C.

Provider Business Mailing Address
First Line	:	1645 N TOWN EAST BLVD
Second Line	:	STE 146
City	:	MESQUITE
State	:	TX
Zip	:	75150-4158
Country	:	US
Telephone Number	:	972-270-0600
Fax Number	:	972-270-0051

Provider Business Practice Location Address
First Line	:	1645 N TOWN EAST BLVD
Second Line	:	STE 146
City	:	MESQUITE
State	:	TX
Zip	:	75150-4146
Country	:	US
Telephone Number	:	972-270-0600
Fax Number	:	972-270-0051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	04/03/2012

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