Healthcare Provider Details

I. General information

NPI: 1972841252
Provider Name (Legal Business Name): LLACA CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 05/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 E OSBORN RD STE 102
SCOTTSDALE AZ
85251-6434
US

IV. Provider business mailing address

7555 E OSBORN RD STE 102
SCOTTSDALE AZ
85251-6434
US

V. Phone/Fax

Practice location:
  • Phone: 480-652-4788
  • Fax: 480-945-7805
Mailing address:
  • Phone: 480-652-4788
  • Fax: 480-945-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number8126
License Number StateAZ

VIII. Authorized Official

Name: DR. REBECCA LLACA
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 480-652-4788