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General NPI Number Information
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NPI Number | 1326297128
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Entity Type | Organization
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Legal Business Name | POWER OF ONE CHIROPRACTIC CLINIC PLC
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 4550 E BELL RD BLDG 6, STE 152
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City | PHOENIX
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State | AZ
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Zip | 85032-9306
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Country | US
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Telephone | 602-992-9791
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Fax | 602-992-1061
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Provider Business Mailing Address
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Address Line | 4550 E BELL RD BLDG 6, STE 152
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City | PHOENIX
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State | AZ
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Zip | 85032-9306
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Country | US
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Telephone | 602-992-9791
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Fax | 602-992-1061
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Authorized Official
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Title or Position | OWNER/ MEMBER
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Name | DR. LAURIE JO RILEY
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Credential | D.C.
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Telephone | 602-402-8515
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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 | 5878
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License Number State | AZ
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