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General NPI Number Information
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NPI Number | 1386825594
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Entity Type | Organization
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Legal Business Name | SUNCLOUD CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 4032 LA LINDA WAY
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-4602
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Country | US
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Telephone | 520-458-1122
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Fax | 520-458-8628
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Provider Business Mailing Address
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Address Line | 4032 LA LINDA WAY
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-4602
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Country | US
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Telephone | 520-458-1122
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Fax | 520-458-8628
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Authorized Official
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Title or Position | OWNER
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Name | DR. RALPH MINOGUE
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Credential | D.C.
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Telephone | 520-458-1122
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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 | 5996
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License Number State | AZ
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