MEDICARE: DESERT SKY CHIROPRACTIC

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	111NR0400X	Rehabilitation Chiropractor		AZ

General Provider Information

NPI Number	:	1932313921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SKY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	4219 E INDIAN SCHOOL RD
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5373
Country	:	US
Telephone Number	:	602-952-2802
Fax Number	:	602-952-2803

Provider Business Practice Location Address
First Line	:	4219 E INDIAN SCHOOL RD
Second Line	:	SUITE 101
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5373
Country	:	US
Telephone Number	:	602-952-2802
Fax Number	:	602-952-2803

Authorized Official
Title or Position	:	OWNER
Name	:	CRAIG HAMELINK
Credential	:
Telephone Number	:	602-952-2802

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/21/2022

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