Healthcare Provider Details
I. General information
NPI: 1700460482
Provider Name (Legal Business Name): REGENT HEALTHCARE AT DC RANCH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18501 N THOMPSON PEAK PKWY
SCOTTSDALE AZ
85255-6087
US
IV. Provider business mailing address
3847 E EXPEDITION WAY
PHOENIX AZ
85050-5483
US
V. Phone/Fax
- Phone: 480-515-4053
- Fax: 480-304-9318
- Phone: 480-234-9436
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHAWN
M
MEYER
Title or Position: PRESIDENT
Credential: DC
Phone: 480-234-9436