Healthcare Provider Details

I. General information

NPI: 1568526556
Provider Name (Legal Business Name): MICHAEL J CASTRICHINI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4619 N 24TH ST
PHOENIX AZ
85016-5203
US

IV. Provider business mailing address

4619 N 24TH ST
PHOENIX AZ
85016-5203
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-0111
  • Fax: 602-956-6789
Mailing address:
  • Phone: 602-956-0111
  • Fax: 602-956-6789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3030
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5338
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: