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General NPI Number Information
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NPI Number | 1568678977
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Entity Type | Organization
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Legal Business Name | OFFNER FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 37955 S CAMINO BLANCO RD
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City | WICKENBURG
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State | AZ
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Zip | 85390-3402
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Country | US
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Telephone | 928-684-1691
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Fax |
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Provider Business Mailing Address
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Address Line | 37955 S CAMINO BLANCO RD
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City | WICKENBURG
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State | AZ
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Zip | 85390-3402
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Country | US
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Telephone | 928-684-1691
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Fax |
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Authorized Official
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Title or Position | SECRETARY OF CORP
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Name | DR. LISA OFFNER
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Credential |
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Telephone | 928-684-1691
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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 | 4494
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4588
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License Number State | AZ
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