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General NPI Number Information
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NPI Number | 1265936140
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Entity Type | Individual
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Provider Name | JESSE ALEXANDER FOX DC
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 930 W BROADWAY RD STE 7
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City | TEMPE
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State | AZ
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Zip | 85282-1269
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Country | US
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Telephone | 480-829-9593
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Fax | 403-653-0004
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Provider Business Mailing Address
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Address Line | 930 W BROADWAY RD STE 7
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City | TEMPE
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State | AZ
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Zip | 85282-1269
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Country | US
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Telephone | 480-829-9593
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Fax | 403-653-0004
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8676
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License Number State | AZ
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