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General NPI Number Information
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NPI Number | 1366796146
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Entity Type | Organization
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Legal Business Name | DISC AND SPINE CENTER L.L.C.
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 7485 E 1ST ST STE
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2241
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Country | US
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Telephone | 928-632-1430
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Fax | 928-632-1430
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Provider Business Mailing Address
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Address Line | 7485 E 1ST ST STE
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2241
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Country | US
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Telephone | 928-632-1430
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Fax | 928-632-1430
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Authorized Official
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Title or Position | OWNER
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Name | DR. VERONICA LYNNE HUDSON
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Credential | D.C.
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Telephone | 928-632-1430
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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 | AZ
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