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General NPI Number Information
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NPI Number | 1366798522
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Entity Type | Organization
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Legal Business Name | DRNATHANSCONLEECHIROPRACTICPHYSICIANPC
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 3020 N COUNTRY CLUB RD
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City | TUCSON
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State | AZ
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Zip | 85716-1603
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Country | US
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Telephone | 520-322-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 N COUNTRY CLUB RD
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City | TUCSON
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State | AZ
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Zip | 85716-1603
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Country | US
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Telephone | 520-322-6161
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. NATHAN CONLEE
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Credential | D.C.
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Telephone | 520-322-6161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4343
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License Number State | AZ
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