Provider Demographics
NPI:1245534999
Name:MAURAGAS, JOELLE M (DC)
Entity type:Individual
Prefix:DR
First Name:JOELLE
Middle Name:M
Last Name:MAURAGAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JOELLE
Other - Middle Name:M
Other - Last Name:RENAUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9 VERDANT CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-2725
Mailing Address - Country:US
Mailing Address - Phone:315-651-6085
Mailing Address - Fax:302-691-7657
Practice Address - Street 1:1010 N BANCROFT PKWY
Practice Address - Street 2:STE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2690
Practice Address - Country:US
Practice Address - Phone:302-543-5679
Practice Address - Fax:302-691-7657
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor