Provider Demographics
NPI:1467476952
Name:MAJERUS, JOSEPH ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROBERT
Last Name:MAJERUS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 DONNER CT
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86406-8336
Mailing Address - Country:US
Mailing Address - Phone:928-680-4446
Mailing Address - Fax:
Practice Address - Street 1:2163 BIRCH SQ STE A
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-6757
Practice Address - Country:US
Practice Address - Phone:928-680-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3515OtherAZ LICENSE #
AZAZ0233020OtherAZ BCBS ID
AZZ75027Medicare ID - Type Unspecified
AZAZ0233020OtherAZ BCBS ID