Provider Demographics
NPI:1699049387
Name:MANOL, ABBY (DC)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:
Last Name:MANOL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:PERSOLEO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:208 N MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4027
Mailing Address - Country:US
Mailing Address - Phone:607-272-0006
Mailing Address - Fax:
Practice Address - Street 1:208 N MEADOW ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4027
Practice Address - Country:US
Practice Address - Phone:607-272-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012144111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition