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General NPI Number Information
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NPI Number | 1376727180
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Entity Type | Organization
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Legal Business Name | PARKWAY CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 10006 W HAPPY VALLEY RD SUITE 1210
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City | PEORIA
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State | AZ
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Zip | 85383-1235
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Country | US
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Telephone | 623-537-3900
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Fax | 623-825-6508
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Provider Business Mailing Address
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Address Line | 8923 W DALEY LN
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City | PEORIA
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State | AZ
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Zip | 85383-1938
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Country | US
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Telephone | 623-537-3900
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Fax | 623-825-6508
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN MICHEELS
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Credential | D.C.
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Telephone | 623-537-3900
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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 | 5567
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License Number State | AZ
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