Healthcare Provider Details

I. General information

NPI: 1518967298
Provider Name (Legal Business Name): RAYMOND JAMES HILLENBRAND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 E INDIAN SCHOOL RD STE 114
SCOTTSDALE AZ
85251-3610
US

IV. Provider business mailing address

2105 E HONEYSUCKLE PL
CHANDLER AZ
85286-2318
US

V. Phone/Fax

Practice location:
  • Phone: 480-284-9072
  • Fax: 480-945-6201
Mailing address:
  • Phone: 480-284-9072
  • Fax: 480-945-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3629
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: