MEDICARE: DR. JEFFREY MAHANEY DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC-04822	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RG852051	OTHER	OH	DRIVERS LICENSE

General Provider Information

NPI Number	:	1326511080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY MAHANEY DC

Provider Business Mailing Address
First Line	:	715 S COY RD STE C
Second Line	:
City	:	OREGON
State	:	OH
Zip	:	43616-3010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 S COY RD STE C
Second Line	:
City	:	OREGON
State	:	OH
Zip	:	43616-3010
Country	:	US
Telephone Number	:	419-567-8438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2019
Last Update Date	:	04/22/2023

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Directions to “ DR. JEFFREY MAHANEY DC” Practice Location

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