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General NPI Number Information
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NPI Number | 1104937838
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC WORKS WEST
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 2515 N SCOTTSDALE RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85257-1352
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Country | US
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Telephone | 480-284-9072
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Fax |
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Provider Business Mailing Address
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Address Line | 854 RAVINE TERRACE DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2721
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Country | US
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Telephone | 480-284-9072
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIOR
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Name | DR. RAYMOND J HILLENBRAND
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Credential | D.C.
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Telephone | 480-284-9072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 3629
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License Number State | AZ
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