Individual
JOSEPH WAYNE MAYHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATS
Contact information
Practice address
2829 PAMPLONA WAY, MODESTO, CA 95354-2016
(209) 604-4516
Mailing address
2829 PAMPLONA WAY, MODESTO, CA 95354-2016
(209) 604-4516
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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