Healthcare Provider Details

I. General information

NPI: 1508060047
Provider Name (Legal Business Name): DR. ALISA JOY COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALISA JOY WECHLSER D.C., C.C.N.

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 N 140TH WAY
SCOTTSDALE AZ
85259-4618
US

IV. Provider business mailing address

10710 N 140TH WAY
SCOTTSDALE AZ
85259-4618
US

V. Phone/Fax

Practice location:
  • Phone: 480-699-9735
  • Fax:
Mailing address:
  • Phone: 480-699-9735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6051
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: