Healthcare Provider Details

I. General information

NPI: 1437811924
Provider Name (Legal Business Name): NEUFANG CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 SOUTH 48TH STREET SUITE 108
PHOENIX AZ
85044-1787
US

IV. Provider business mailing address

11011 SOUTH 48TH STREET SUITE 108
PHOENIX AZ
85044-1787
US

V. Phone/Fax

Practice location:
  • Phone: 480-893-2400
  • Fax: 480-553-9545
Mailing address:
  • Phone: 480-893-2400
  • Fax: 480-553-9545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC JAMES NEUFANG
Title or Position: OWNER
Credential: D.C.
Phone: 480-893-2400