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Organization
MASTERPEACE CHIROPRACTIC CENTER, P.C.
Active
Organization
MASTERPEACE CHIROPRACTIC CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD J MANNINO D.C. (PRESIDENT)
(703) 490-4242
Entity
Organization
Contact information
Practice address
3302 OLD BRIDGE RD, SUITE GH, LAKE RIDGE, VA 22192-5262
(703) 490-4242
(703) 491-6370
Mailing address
3302 OLD BRIDGE RD, SUITE GH, LAKE RIDGE, VA 22192-5262
(703) 490-4242
(703) 491-6370
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000675
VA
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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