Provider Demographics
NPI:1528103322
Name:MAYES CHIROPRACTIC, INC
Entity type:Organization
Organization Name:MAYES CHIROPRACTIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:CORONE
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-375-9000
Mailing Address - Street 1:5975 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-3012
Mailing Address - Country:US
Mailing Address - Phone:208-375-9000
Mailing Address - Fax:208-375-9032
Practice Address - Street 1:5975 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-3012
Practice Address - Country:US
Practice Address - Phone:208-375-9000
Practice Address - Fax:208-375-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty