MEDICARE: DEVON RAY MADRID D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9437	AZ

General Provider Information

NPI Number	:	1902693088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVON RAY MADRID D.C.

Provider Business Mailing Address
First Line	:	2450 S 4TH AVE STE 108A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7234
Country	:	US
Telephone Number	:	760-413-1530
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 S 4TH AVE STE A2450S4
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8573
Country	:	US
Telephone Number	:	760-413-1530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	08/01/2025

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