MEDICARE: FOOTHILLS FAMILY CHIROPRACTIC, INC

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	7893	AZ

General Provider Information

NPI Number	:	1588840664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOTHILLS FAMILY CHIROPRACTIC, INC

Provider Business Mailing Address
First Line	:	1241 E CHANDLER BLVD STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-4605
Country	:	US
Telephone Number	:	480-460-1399
Fax Number	:	480-460-1880

Provider Business Practice Location Address
First Line	:	1241 E CHANDLER BLVD STE 122
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-4605
Country	:	US
Telephone Number	:	480-460-1399
Fax Number	:	480-460-1880

Authorized Official
Title or Position	:	BILLING COORDINATOR
Name	:	DEBORAH SUE HUNSLEY
Credential	:	NCICS
Telephone Number	:	623-256-2698

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	06/20/2008

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