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General NPI Number Information
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NPI Number | 1356580682
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Entity Type | Organization
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Legal Business Name | AZ CHIRO LLC
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Dates
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Enumeration Date | 02/10/2009
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Last Update Date | 04/06/2009
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Provider Practice Location Address
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Address Line | 8996 W UNION HILLS DR STE 103
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City | PEORIA
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State | AZ
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Zip | 85382-3010
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Country | US
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Telephone | 623-986-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 20403 N LAKE PLEASANT RD STE 117-202
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City | PEORIA
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State | AZ
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Zip | 85382-9702
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Country | US
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Telephone | 623-986-0343
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN BLAKE BIDDULPH
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Credential | D.C
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Telephone | 801-802-9900
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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 |
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License Number State |
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