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Individual

LUIGI MANZOLILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
280 BROADWAY, PROVIDENCE, RI 02903-3007
(401) 273-0046
(401) 273-4100
Mailing address
280 BROADWAY, PROVIDENCE, RI 02903-3007
(401) 273-0046
(401) 273-4100

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC00321
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35440
BLUE CROSS
01
4400054
UNITED
Enumeration date
09/07/2005
Last updated
02/29/2008
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