Healthcare Provider Details

I. General information

NPI: 1558558403
Provider Name (Legal Business Name): PRICE VENTURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 E GUADALUPE RD SUITE 112
TEMPE AZ
85283-3273
US

IV. Provider business mailing address

1855 E GUADALUPE RD SUITE 112
TEMPE AZ
85283-3273
US

V. Phone/Fax

Practice location:
  • Phone: 480-839-8552
  • Fax: 480-756-7978
Mailing address:
  • Phone: 480-839-8552
  • Fax: 480-752-7978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEREK CHRISTOPHER PRICE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 480-839-8552