Provider Demographics
NPI:1679634877
Name:MAUVAIS, TROY M (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:M
Last Name:MAUVAIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:8836 GREENBACK LN
Mailing Address - Street 2:STE B
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662
Mailing Address - Country:US
Mailing Address - Phone:916-990-0900
Mailing Address - Fax:916-990-0906
Practice Address - Street 1:8836 GREENBACK LN
Practice Address - Street 2:STE B
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662
Practice Address - Country:US
Practice Address - Phone:916-990-0900
Practice Address - Fax:916-990-0906
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor