Healthcare Provider Details

I. General information

NPI: 1669918629
Provider Name (Legal Business Name): ELLIE JIALING LAW DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE CARLING LAW DC

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 E PALM LANE SUITE A200
PHOENIX AZ
85004
US

IV. Provider business mailing address

340 E PALM LANE SUITE A200
PHOENIX AZ
85004
US

V. Phone/Fax

Practice location:
  • Phone: 928-393-5798
  • Fax:
Mailing address:
  • Phone: 928-393-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60575908
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberCH60575908
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: