Provider Demographics
NPI:1174560973
Name:MAYFIELD, RICHARD L (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3601 MINNESOTA DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5281
Mailing Address - Country:US
Mailing Address - Phone:952-885-0822
Mailing Address - Fax:952-885-9180
Practice Address - Street 1:3601 MINNESOTA DR
Practice Address - Street 2:SUITE 160
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5281
Practice Address - Country:US
Practice Address - Phone:952-885-0822
Practice Address - Fax:952-885-9180
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1758111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition