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General NPI Number Information
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NPI Number | 1134710288
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Entity Type | Organization
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Legal Business Name | AZ CHIROPRACTIC
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 3570 S VAL VISTA DR STE 110
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City | GILBERT
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State | AZ
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Zip | 85297-7327
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Country | US
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Telephone | 480-899-9923
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Fax | 480-899-0196
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Provider Business Mailing Address
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Address Line | 3570 S VAL VISTA DR STE 110
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City | GILBERT
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State | AZ
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Zip | 85297-7327
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Country | US
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Telephone | 480-899-9923
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Fax | 480-899-0196
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY HIRST
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Credential | DC
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Telephone | 480-899-9923
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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 |
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License Number State |
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