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NPI Code Detail

MEDICARE: DR. RICHARD JOSEPH SPINA D.C.

MEDICARE: DR. RICHARD JOSEPH SPINA 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
1111N00000XChiropractor4769AZ

General Provider Information

NPI Number : 1588709919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD JOSEPH SPINA D.C.
Provider Business Mailing Address
First Line : 12423 N 59TH PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-4331
Country : US
Telephone Number : 480-368-0524
Fax Number :
Provider Business Practice Location Address
First Line : 1640 EAST THOMAS ROAD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-7602
Country : US
Telephone Number : 602-248-9141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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