Healthcare Provider Details

I. General information

NPI: 1033652813
Provider Name (Legal Business Name): VSC SCOTTSDALE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 E BELL RD STE 109
SCOTTSDALE AZ
85254-1256
US

IV. Provider business mailing address

5533 E BELL RD STE 109
SCOTTSDALE AZ
85254-1256
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-4200
  • Fax:
Mailing address:
  • Phone: 602-788-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN PIERCE
Title or Position: OWNER
Credential: D.C.
Phone: 602-788-4200