Healthcare Provider Details

I. General information

NPI: 1861471005
Provider Name (Legal Business Name): MICHAEL VINCENT HEALEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 04/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8952 E DESERT COVE DR #105
SCOTTSDALE AZ
85260-6776
US

IV. Provider business mailing address

8952 E DESERT COVE DR STE 105
SCOTTSDALE AZ
85260-6776
US

V. Phone/Fax

Practice location:
  • Phone: 480-657-9202
  • Fax: 480-657-9341
Mailing address:
  • Phone: 480-657-9202
  • Fax: 480-657-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7538
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: