Healthcare Provider Details

I. General information

NPI: 1932313921
Provider Name (Legal Business Name): DESERT SKY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 E INDIAN SCHOOL RD SUITE 101
PHOENIX AZ
85018-5373
US

IV. Provider business mailing address

4219 E INDIAN SCHOOL RD SUITE 101
PHOENIX AZ
85018-5373
US

V. Phone/Fax

Practice location:
  • Phone: 602-952-2802
  • Fax: 602-952-2803
Mailing address:
  • Phone: 602-952-2802
  • Fax: 602-952-2803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateAZ

VIII. Authorized Official

Name: CRAIG HAMELINK
Title or Position: OWNER
Credential:
Phone: 602-952-2802