Healthcare Provider Details

I. General information

NPI: 1487097200
Provider Name (Legal Business Name): DYANA LEEANN MULVIHILL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 W UNION HILLS DR STE 7
PHOENIX AZ
85027-6629
US

IV. Provider business mailing address

602 W UNION HILLS DR STE 7
PHOENIX AZ
85027-6629
US

V. Phone/Fax

Practice location:
  • Phone: 623-492-0999
  • Fax:
Mailing address:
  • Phone: 623-492-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8315
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: