| NPI | 1932404316 |
|---|---|
| Doing Business As | PROFORMANCE HEALTH OF GLENDALE |
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY MANCUSO President 480-510-3566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5012) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2012-02-10 |