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General NPI Number Information
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NPI Number | 1316530181
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Entity Type | Individual
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Provider Name | MANDY ANN BOYLE DC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 1551 BISHOP ST # C-320
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4635
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Country | US
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Telephone | 805-439-2828
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Fax | 805-439-2839
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Provider Business Mailing Address
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Address Line | 110 DEER TRAIL CIR
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-1315
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Country | US
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Telephone | 281-352-4748
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Fax | 805-439-2839
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14701
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | DC36033
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License Number State | CA
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