Healthcare Provider Details

I. General information

NPI: 1730244658
Provider Name (Legal Business Name): ANDREA JOY RUZICKA B.S., D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 W BROADWAY RD STE 7
TEMPE AZ
85282-1269
US

IV. Provider business mailing address

3850 E SHOMI ST
PHOENIX AZ
85044-3850
US

V. Phone/Fax

Practice location:
  • Phone: 480-829-9593
  • Fax: 480-829-9594
Mailing address:
  • Phone: 480-785-5150
  • Fax: 480-829-9593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5938
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number3541
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: