Provider Demographics
NPI:1902905482
Name:MANNINO, GUY CHRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:CHRIS
Last Name:MANNINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OLD STEESE HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3160
Mailing Address - Country:US
Mailing Address - Phone:907-474-0636
Mailing Address - Fax:907-474-0637
Practice Address - Street 1:201 OLD STEESE HWY STE 4
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3160
Practice Address - Country:US
Practice Address - Phone:907-474-0636
Practice Address - Fax:907-474-0637
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor