=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396946851
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN PERI TAMES D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2007
-----------------------------------------------------
Last Update Date | 07/27/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10613 N HAYDEN RD SUITE J-108
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-5683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-315-8444
-----------------------------------------------------
Fax | 480-315-1244
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31396 N 60TH ST
-----------------------------------------------------
City | CAVE CREEK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85331-3069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-206-8071
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 5331
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 3027
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------