Healthcare Provider Details

I. General information

NPI: 1467374165
Provider Name (Legal Business Name): AZ CHIRO & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 W HAPPY VALLEY RD STE B105
GLENDALE AZ
85310-2608
US

IV. Provider business mailing address

6615 W HAPPY VALLEY RD STE B105
GLENDALE AZ
85310-2608
US

V. Phone/Fax

Practice location:
  • Phone: 623-572-9820
  • Fax:
Mailing address:
  • Phone: 623-572-9820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATIE D BUCHKOWSKI
Title or Position: OWNER CONTROLLER
Credential:
Phone: 602-770-6323