Provider Demographics
NPI:1164002028
Name:MAUTHE, ERIN M (DC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:MAUTHE
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 1:4500 ARROWHEAD RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-5986
Mailing Address - Country:US
Mailing Address - Phone:505-867-1122
Mailing Address - Fax:
Practice Address - Street 1:4500 ARROWHEAD RIDGE DR SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-5986
Practice Address - Country:US
Practice Address - Phone:505-867-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC2266111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner