Provider Demographics
NPI:1134503311
Name:MAYES, CALVIN J (DC)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:J
Last Name:MAYES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JAKE
Other - Middle Name:
Other - Last Name:MAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:4532 MCMURRY AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8022
Mailing Address - Country:US
Mailing Address - Phone:970-294-4150
Mailing Address - Fax:970-286-2913
Practice Address - Street 1:4532 MCMURRY AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-8022
Practice Address - Country:US
Practice Address - Phone:970-294-4150
Practice Address - Fax:970-286-2913
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor