MEDICARE: NGO-USREY CHIROPRACTIC, PLLC

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	7971	AZ

General Provider Information

NPI Number	:	1083985618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGO-USREY CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	2571 N 1ST AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2910
Country	:	US
Telephone Number	:	520-622-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	2571 N 1ST AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-2910
Country	:	US
Telephone Number	:	520-622-8914
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DEVA USREY
Credential	:	D.C.
Telephone Number	:	520-622-8914

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	01/12/2012

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