Provider Demographics
NPI:1962571042
Name:ROYER, MARIE CAFASSO (DC)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:CAFASSO
Last Name:ROYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 CAPITOLA RD
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-3810
Mailing Address - Country:US
Mailing Address - Phone:831-475-7527
Mailing Address - Fax:831-476-7781
Practice Address - Street 1:4895 CAPITOLA RD
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3810
Practice Address - Country:US
Practice Address - Phone:831-475-7527
Practice Address - Fax:831-476-7781
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0243040Medicare ID - Type Unspecified