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General NPI Number Information
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NPI Number | 1326395757
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Entity Type | Organization
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Legal Business Name | SUMMIT CHIROPRACTIC & REHABILITATION INC
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Dates
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Enumeration Date | 08/03/2012
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 519 N LEROUX ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3221
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Country | US
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Telephone | 928-774-7315
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Fax |
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Provider Business Mailing Address
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Address Line | 519 N LEROUX ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3221
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Country | US
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Telephone | 928-774-7315
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NATHAN BELCHER
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Credential | D.C.
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Telephone | 928-699-0512
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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 | 7734
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License Number State | AZ
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