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General NPI Number Information
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NPI Number | 1255691689
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Entity Type | Organization
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Legal Business Name | ACHIEVING BALANCE CHIROPRACTIC & WELLNESS, PLLC.
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 8060 E GELDING DR STE 104
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6960
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Country | US
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Telephone | 602-678-9886
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Fax |
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Provider Business Mailing Address
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Address Line | 8060 E GELDING DR STE 104
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6960
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Country | US
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Telephone | 602-678-9886
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RUSSELL HAROLD LYTTON
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Credential | D.C.
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Telephone | 602-578-9886
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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 | 8234
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License Number State | AZ
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