Individual
DR. RUSSELL WORTH MANKTELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1111 N GILBERT RD, 115, GILBERT, AZ 85234-2313
(480) 892-5631
(480) 892-5649
Mailing address
1111 N GILBERT RD, 115, GILBERT, AZ 85234-2313
(480) 892-5631
(480) 892-5649
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7839
AZ
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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