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General NPI Number Information
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NPI Number | 1639545247
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Entity Type | Organization
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Legal Business Name | MAYO CHIROPRACTIC INC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 03/06/2019
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Provider Practice Location Address
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Address Line | 2180 GARNET AVE STE 3D
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City | SAN DIEGO
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State | CA
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Zip | 92109
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Country | US
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Telephone | 619-693-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 2180 GARNET AVE STE 3D
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City | SAN DIEGO
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State | CA
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Zip | 92109
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Country | US
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Telephone | 619-693-6389
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Fax |
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Authorized Official
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Title or Position | OWNER, CHIROPRACTOR
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Name | EMILY MAYO
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Credential | DC
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Telephone | 619-693-6389
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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 | CHIR009517
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33367
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License Number State | CA
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