Healthcare Provider Details
I. General information
NPI: 1508387713
Provider Name (Legal Business Name): AR FOOTE CHIROPRACTIC & HEALTH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/28/2017
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2080 W SOUTHERN AVE BLDG A2
APACHE JUNCTION AZ
85120-7656
US
IV. Provider business mailing address
22048 E PECAN DR
QUEEN CREEK AZ
85142-4895
US
V. Phone/Fax
- Phone: 480-982-6568
- Fax: 480-982-6568
- Phone: 480-982-6568
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 7686 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
ALEXANDER
RAY
FOOTE
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 480-982-6568