Provider Demographics
NPI:1467987693
Name:MARIE CAFASSO ROYER CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:MARIE CAFASSO ROYER CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:CAFASSO
Authorized Official - Last Name:ROYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:831-465-9088
Mailing Address - Street 1:740 FRONT ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4535
Mailing Address - Country:US
Mailing Address - Phone:831-465-9088
Mailing Address - Fax:831-465-8528
Practice Address - Street 1:740 FRONT ST
Practice Address - Street 2:SUITE 130
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4535
Practice Address - Country:US
Practice Address - Phone:831-465-9088
Practice Address - Fax:831-465-8528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty