Healthcare Provider Details

I. General information

NPI: 1760437701
Provider Name (Legal Business Name): ALEXANDER RAY FOOTE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/14/2017
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

22048E PECAN DR
QUEEN CREEK AZ
85142-4895
US

V. Phone/Fax

Practice location:
  • Phone: 480-982-6568
  • Fax: 480-982-6568
Mailing address:
  • Phone: 480-459-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7686
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: