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General NPI Number Information
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NPI Number | 1346451408
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Entity Type | Organization
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Legal Business Name | COMPLETE CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 4915 E BASELINE ROAD SUITE 101
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City | GILBERT
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State | AZ
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Zip | 85234-2966
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Country | US
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Telephone | 480-926-7100
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Fax | 480-926-7101
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Provider Business Mailing Address
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Address Line | 4915 E BASELINE ROAD SUITE 101
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City | GILBERT
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State | AZ
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Zip | 85234-2966
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Country | US
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Telephone | 480-926-7100
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Fax | 480-926-7101
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE K RESNICK
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Credential | D.C.
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Telephone | 480-926-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 5756
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License Number State | AZ
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