MEDICARE: DR. PHILLIP J. FIERRO D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5444	AZ

General Provider Information

NPI Number	:	1013097930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP J. FIERRO D.C.

Provider Business Mailing Address
First Line	:	16421 N TATUM BLVD STE 201
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3457
Country	:	US
Telephone Number	:	602-485-8000
Fax Number	:	602-485-8010

Provider Business Practice Location Address
First Line	:	16421 N TATUM BLVD STE 201
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3457
Country	:	US
Telephone Number	:	602-485-8000
Fax Number	:	602-485-8010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	09/11/2015

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