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General NPI Number Information
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NPI Number | 1104496769
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Entity Type | Individual
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Provider Name | ELIZABETH ROSE CERNY DC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 10200 W HAPPY VALLEY PKWY
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City | PEORIA
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State | AZ
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Zip | 85383-2878
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Country | US
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Telephone | 623-432-2543
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Fax |
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Provider Business Mailing Address
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Address Line | 13301 N 84TH AVE
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City | PEORIA
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State | AZ
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Zip | 85381-4863
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Country | US
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Telephone | 785-844-5448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9076
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License Number State | AZ
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