Healthcare Provider Details

I. General information

NPI: 1962957571
Provider Name (Legal Business Name): RAPHAEL P MENDEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RALPH MENDEL D.C.

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLSIDE ST
ASHEVILLE NC
28801-1355
US

IV. Provider business mailing address

300 HILLSIDE ST
ASHEVILLE NC
28801-1355
US

V. Phone/Fax

Practice location:
  • Phone: 828-785-1475
  • Fax:
Mailing address:
  • Phone: 828-785-1475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4665
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: