Provider Demographics
NPI:1063554335
Name:VEGHER, MARY MARGARET (DC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:MARGARET
Last Name:VEGHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45310 PACIFICA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CASPAR
Mailing Address - State:CA
Mailing Address - Zip Code:95420-0148
Mailing Address - Country:US
Mailing Address - Phone:707-964-1855
Mailing Address - Fax:760-446-2298
Practice Address - Street 1:45310 PACIFICA DR
Practice Address - Street 2:SUITE 2
Practice Address - City:CASPAR
Practice Address - State:CA
Practice Address - Zip Code:95420-0148
Practice Address - Country:US
Practice Address - Phone:707-964-1855
Practice Address - Fax:760-446-2298
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U06263Medicare UPIN
DC0193130Medicare ID - Type Unspecified