Healthcare Provider Details

I. General information

NPI: 1376728675
Provider Name (Legal Business Name): DARRE HOLDINGS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15027 W BELL RD SUITE 100
SURPRISE AZ
85374-3216
US

IV. Provider business mailing address

15027 W BELL RD SUITE 100
SURPRISE AZ
85374-3216
US

V. Phone/Fax

Practice location:
  • Phone: 623-215-4107
  • Fax: 623-215-7453
Mailing address:
  • Phone: 623-215-4107
  • Fax: 623-215-7453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7436
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0468
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number07-992
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHELLE R COATS
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 623-215-4107