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General NPI Number Information
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NPI Number | 1922698414
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Entity Type | Organization
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Legal Business Name | MAZZAFERRO CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 1655 SW HIGHLAND AVE STE 6
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City | REDMOND
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State | OR
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Zip | 97756-2558
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Country | US
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Telephone | 541-923-2019
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 SW HIGHLAND AVE STE 6
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City | REDMOND
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State | OR
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Zip | 97756-2558
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Country | US
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Telephone | 541-923-2019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ADAMO MAZZAFERRO
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Credential | DC
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Telephone | 707-721-7018
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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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