MEDICARE: DR. KAMI L.R. MAHONY D.C.

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	CH00034410	WA
2	111N00000X	Chiropractor	08003156A	IN

General Provider Information

NPI Number	:	1821110750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMI L.R. MAHONY D.C.

Provider Business Mailing Address
First Line	:	7021 GARMAN RD.
Second Line	:
City	:	AUBURN
State	:	IN
Zip	:	46706
Country	:	US
Telephone Number	:	260-687-0542
Fax Number	:	260-627-0772

Provider Business Practice Location Address
First Line	:	8422 UNION CHAPEL RD.
Second Line	:
City	:	FT. WAYNE
State	:	IN
Zip	:	46845
Country	:	US
Telephone Number	:	260-319-1126
Fax Number	:	260-627-0772

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	11/30/2021

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