Healthcare Provider Details

I. General information

NPI: 1013584507
Provider Name (Legal Business Name): TRUE NORTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 E SHEA BLVD STE 165
PHOENIX AZ
85028-6042
US

IV. Provider business mailing address

4530 E SHEA BLVD STE 165
PHOENIX AZ
85028-6042
US

V. Phone/Fax

Practice location:
  • Phone: 602-603-1490
  • Fax:
Mailing address:
  • Phone: 602-603-1490
  • Fax: 480-800-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER BONIN
Title or Position: PRESIDENT
Credential: DC
Phone: 602-603-1490