Provider Demographics
NPI:1306170824
Name:MANZO, VICTOR JR (DC)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:MANZO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 TIMBER HIGHLANDS LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2395
Mailing Address - Country:US
Mailing Address - Phone:865-567-6237
Mailing Address - Fax:
Practice Address - Street 1:2412 W ANDREW JOHNSON HWY STE H
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3276
Practice Address - Country:US
Practice Address - Phone:865-214-7438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty