Individual
DR. JEFFREY JOHN MANUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2236 WEST 38TH STREET, ERIE, PA 16506
(814) 868-2663
(814) 868-0044
Mailing address
2236 WEST 38TH STREET, ERIE, PA 16506
(814) 868-2663
(814) 868-0044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC005117L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001432216000
—
PA
05
—
0014322160003
—
PA
01
—
182925
BLUE SHIELD
PA
01
—
335-715
BLUE SHIELD GROUP NUMBER
PA
01
—
JM1033899
ASHN
PA
Enumeration date
10/25/2005
Last updated
02/12/2010
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