Organization
MAYFIELD CHRIOPRACTIC WEST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAM MAYFIELD D.C. (PRESIDENT)
(318) 396-5558
Entity
Organization
Contact information
Practice address
4900 CYPRESS ST, SIUTE 13, WEST MONROE, LA 71291-7670
(318) 396-5558
(318) 396-9119
Mailing address
PO BOX 2274, WEST MONROE, LA 71294-2274
(318) 396-5558
(318) 396-9119
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1352
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4050634820
BLUE CROSS BLUE SHIELD LA
LA
Enumeration date
03/01/2007
Last updated
07/01/2011
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