Healthcare Provider Details

I. General information

NPI: 1275625279
Provider Name (Legal Business Name): DARREN JOHN GROZIER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16222 N 59TH AVE
GLENDALE AZ
85306-1701
US

IV. Provider business mailing address

16222 N 59TH AVE
GLENDALE AZ
85306-1701
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax: 623-334-4400
Mailing address:
  • Phone: 623-334-4000
  • Fax: 623-334-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5646
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: