Provider Demographics
NPI:1194550418
Name:MANFREDI CHIROPRACTIC PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MANFREDI CHIROPRACTIC PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANFREDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-512-2507
Mailing Address - Street 1:41969 MARGARITA RD APT 40
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-2817
Mailing Address - Country:US
Mailing Address - Phone:818-512-2507
Mailing Address - Fax:
Practice Address - Street 1:945 S MISSION RD
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3202
Practice Address - Country:US
Practice Address - Phone:818-512-2507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty