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General NPI Number Information
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NPI Number | 1497703243
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Entity Type | Organization
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Legal Business Name | YAVAPAI CHIROPRACTIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3075 N WINDSONG DR SUITE B1
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-1208
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Country | US
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Telephone | 928-775-8750
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Fax | 928-775-8750
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Provider Business Mailing Address
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Address Line | 3075 N WINDSONG DR SUITE B1
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-1208
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Country | US
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Telephone | 928-775-8750
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Fax | 928-775-8750
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. THOMAS LEWIS SANIO
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Credential | D.C.
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Telephone | 928-775-8750
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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 | 7620
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License Number State | AZ
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