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General NPI Number Information
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NPI Number | 1508074022
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Entity Type | Organization
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Legal Business Name | NATURALLY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8800 E. RAINTREE DR. SUITE 175
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City | SCOTTSDALE
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State | AZ
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Zip | 85260
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Country | US
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Telephone | 480-614-5560
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Fax | 480-614-5460
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Provider Business Mailing Address
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Address Line | 1646 N LITCHFIELD RD STE 100
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City | GOODYEAR
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State | AZ
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Zip | 85338-1270
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Country | US
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Telephone | 480-614-5560
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Fax | 480-614-5460
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Authorized Official
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Title or Position | MANAGING CHIROPRACTOR
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Name | MARK WIREMAN
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Credential | DC
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Telephone | 480-614-5560
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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 | 7115
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License Number State | AZ
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