Healthcare Provider Details

I. General information

NPI: 1134670870
Provider Name (Legal Business Name): GARY HENDRIX PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 N ARIZONA BLVD
COOLIDGE AZ
85128-3921
US

IV. Provider business mailing address

803 N ARIZONA BLVD
COOLIDGE AZ
85128-3921
US

V. Phone/Fax

Practice location:
  • Phone: 520-723-3441
  • Fax:
Mailing address:
  • Phone: 520-723-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4768
License Number StateAZ

VIII. Authorized Official

Name: GARY HENDRIX
Title or Position: MEMBER
Credential: DC
Phone: 520-723-3441