Mangan Chiropractic Clinic, S.c. | |
1510 48th Street Pl, Moline, IL 61265-3637 | |
(309) 797-4000 | |
(309) 797-5041 |
Full Name | Mangan Chiropractic Clinic, S.c. |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 1510 48th Street Pl, Moline, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053634204 | NPI | - | NPPES |
038006108 | Medicaid | IL | |
08182055 | Other | IL | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 038006108 (Illinois) | Primary |
Provider Name | Harlene Rosemary Mangan |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1639256118 PECOS PAC ID: 6709916505 Enrollment ID: I20100604000415 |
Mailing Address | Practice Location Address |
---|---|
Mangan Chiropractic Clinic, S.c. 1510 48th Street Pl, Moline, IL 61265-3637 Ph: (309) 797-4000 | Mangan Chiropractic Clinic, S.c. 1510 48th Street Pl, Moline, IL 61265-3637 Ph: (309) 797-4000 |
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