Individual
ANDY MAYHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
431 HUMBOLDT ST, #D, SANTA ROSA, CA 95404-4287
(707) 480-7419
Mailing address
431 HUMBOLDT ST, #D, SANTA ROSA, CA 95404-4287
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
142012
CA
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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