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General NPI Number Information
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NPI Number | 1538267760
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Entity Type | Organization
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Legal Business Name | CACTUS CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8426 W PEORIA AVE STE B
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City | PEORIA
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State | AZ
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Zip | 85345
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Country | US
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Telephone | 623-979-3998
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Fax | 623-878-5976
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Provider Business Mailing Address
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Address Line | 8426 W PEORIA AVE STE B
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City | PEORIA
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State | AZ
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Zip | 85345
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Country | US
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Telephone | 623-979-3998
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Fax | 623-878-5976
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Authorized Official
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Title or Position | OWNER
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Name | CATHERINE A DEVORE MEEHAN
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Credential | D.C.
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Telephone | 623-979-3998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | AZ
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