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General NPI Number Information
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NPI Number | 1194546135
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Entity Type | Organization
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Legal Business Name | INJURY RELIEF CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 980 S WATSON RD STE 105
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City | BUCKEYE
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State | AZ
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Zip | 85326-3433
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Country | US
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Telephone | 602-899-0494
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Fax |
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Provider Business Mailing Address
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Address Line | 10750 W MCDOWELL RD STE F600
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City | AVONDALE
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State | AZ
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Zip | 85392-5971
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Country | US
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Telephone | 787-934-6759
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOSE JUAN CRUZ
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Credential | DC
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Telephone | 602-899-0494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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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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