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General NPI Number Information
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NPI Number | 1417458951
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Entity Type | Organization
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Legal Business Name | SEDONA SPINE & WELLNESS LLC
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 495 NORBIE RD
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City | SEDONA
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State | AZ
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Zip | 86336-4127
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Country | US
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Telephone | 928-963-0180
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Fax |
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Provider Business Mailing Address
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Address Line | 495 NORBIE RD
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City | SEDONA
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State | AZ
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Zip | 86336-4127
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Country | US
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Telephone | 928-963-0180
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JEFFREY MICHAEL FARNHAM
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Credential | DC
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Telephone | 928-963-0180
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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 | 8423
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License Number State | AZ
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