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General NPI Number Information
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NPI Number | 1215108170
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Entity Type | Organization
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Legal Business Name | VAN METRE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 13754 W BELL RD STE 2
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City | SURPRISE
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State | AZ
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Zip | 85374-3879
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Country | US
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Telephone | 623-209-2225
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Fax | 623-584-2311
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Provider Business Mailing Address
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Address Line | 13754 W BELL RD STE 2
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City | SURPRISE
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State | AZ
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Zip | 85374-3879
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Country | US
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Telephone | 623-209-2225
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Fax | 623-584-2311
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Authorized Official
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Title or Position | OWNER
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Name | KIRK W VAN METRE
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Credential | D.C.
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Telephone | 623-209-2225
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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 | 5930
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License Number State | AZ
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