Healthcare Provider Details

I. General information

NPI: 1871985481
Provider Name (Legal Business Name): CHIROFIT GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 W THUNDERBIRD RD
PEORIA AZ
85381-4803
US

IV. Provider business mailing address

8440 W THUNDERBIRD RD
PEORIA AZ
85381-4803
US

V. Phone/Fax

Practice location:
  • Phone: 602-395-0718
  • Fax: 602-343-7973
Mailing address:
  • Phone: 602-395-0718
  • Fax: 602-343-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT STAMP
Title or Position: OWNER
Credential: D.C.
Phone: 602-395-0718