Healthcare Provider Details

I. General information

NPI: 1700820271
Provider Name (Legal Business Name): JOSEPH GEORGE MAIER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 NE KIRBY ST
MCMINNVILLE OR
97128-4320
US

IV. Provider business mailing address

315 NE KIRBY ST
MCMINNVILLE OR
97128-4320
US

V. Phone/Fax

Practice location:
  • Phone: 503-472-2111
  • Fax: 503-434-5886
Mailing address:
  • Phone: 503-472-2111
  • Fax: 503-434-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number3576
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: