Individual
DR. SHANTAI IRENE MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC, BSC
Contact information
Practice address
9090 RIDGELINE BLVD STE 205, HIGHLANDS RANCH, CO 80129-2505
(303) 683-9494
Mailing address
9090 RIDGELINE BLVD STE 205, HIGHLANDS RANCH, CO 80129-2505
(303) 683-9494
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHR-0008097
CO
Other
Enumeration date
11/19/2019
Last updated
01/31/2024
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