Individual
DR. TIMOTHY DE VILLA MANGLICMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1636 SARDIS RD N STE 130, CHARLOTTE, NC 28270-2411
(980) 245-2852
Mailing address
1636 SARDIS RD N STE 130, CHARLOTTE, NC 28270-2411
(980) 245-2852
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5728
NC
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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