Dyllon Mawn, DC | |
2500 1st Ave N, Saint Petersburg, FL 33713-8702 | |
(727) 329-6106 | |
Not Available |
Full Name | Dyllon Mawn |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 2500 1st Ave N, Saint Petersburg, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053066910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH13631 (Florida) | Primary |
Provider Name | Mawn Chiropractic Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1306418678 PECOS PAC ID: 0941684716 Enrollment ID: O20220826003116 |
Mailing Address | Practice Location Address |
---|---|
Dyllon Mawn, DC 5751 11th St S, Saint Petersburg, FL 33705-5021 Ph: (561) 876-2157 | Dyllon Mawn, DC 2500 1st Ave N, Saint Petersburg, FL 33713-8702 Ph: (727) 329-6106 |
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