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General NPI Number Information
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NPI Number | 1104930650
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Entity Type | Organization
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Legal Business Name | ADVANCED CHIROPRACTIC & WELLNESS CENTER, INC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 5730 W PEORIA AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-1423
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Country | US
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Telephone | 623-878-5991
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5325
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City | GLENDALE
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State | AZ
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Zip | 85312-5325
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Country | US
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Telephone | 623-334-9200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES ATKINSON
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Credential |
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Telephone | 623-878-5991
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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 | AZ 6018
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License Number State | AZ
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