Healthcare Provider Details

I. General information

NPI: 1831448869
Provider Name (Legal Business Name): MAYNARD CHIROPRACTIC & WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 NORTH SCOTTSDALE RD
SCOTTSDALE AZ
85257
US

IV. Provider business mailing address

1920 NORTH SCOTTSDALE RD
SCOTTSDALE AZ
85257
US

V. Phone/Fax

Practice location:
  • Phone: 480-994-0072
  • Fax: 480-994-8527
Mailing address:
  • Phone: 480-994-0072
  • Fax: 480-994-8527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3205
License Number StateAZ

VIII. Authorized Official

Name: CURTIS P MAYNARD
Title or Position: OWNER
Credential: D.C.
Phone: 480-994-0072