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Individual

DR. DAVID A MANCUSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
18205 N 51ST AVE, SUITE 113, GLENDALE, AZ 85308-1490
(602) 354-4370
(602) 354-4695
Mailing address
16558 N 104TH WAY, SCOTTSDALE, AZ 85255-2463
(480) 510-3566
(480) 556-1461

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5012
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0243590
BLUE CROSS BLUE SHIELD
AZ
01
AZ8843
HEALTH NET
AZ
Enumeration date
08/31/2006
Last updated
08/09/2012
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