Healthcare Provider Details

I. General information

NPI: 1396791273
Provider Name (Legal Business Name): ALISSA A CLANCEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 PRINCETON PIKE BLDG. 1A
LAWRENCEVILLE NJ
08648-2201
US

IV. Provider business mailing address

2525 S RURAL RD SUITE 4N
TEMPE AZ
85282-2435
US

V. Phone/Fax

Practice location:
  • Phone: 609-912-0440
  • Fax: 609-912-1908
Mailing address:
  • Phone: 480-394-0440
  • Fax: 480-394-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00611100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7836
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4526
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: