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General NPI Number Information
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NPI Number | 1871250639
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Entity Type | Organization
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Legal Business Name | MAHONY-RATHBURN CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 8422 UNION CHAPEL RD.
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City | FT. WAYNE
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State | IN
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Zip | 46845
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Country | US
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Telephone | 260-319-1126
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Fax | 260-627-0772
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Provider Business Mailing Address
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Address Line | 7021 GARMAN RD.
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City | AUBURN
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State | IN
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Zip | 46706
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Country | US
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Telephone | 260-319-1126
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Fax | 260-627-0772
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAMI L. RATHBURN MAHONY
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Credential | D.C.
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Telephone | 260-687-0542
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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 |
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License Number State |
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