=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609184738
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ULTIMATE HEALTHCARE AND FITNESS SYSTEMS PLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2010
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 43553 W ASKEW DR
-----------------------------------------------------
City | MARICOPA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85138-8920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-568-7667
-----------------------------------------------------
Fax | 520-316-6677
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43553 W ASKEW DR
-----------------------------------------------------
City | MARICOPA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85138-8920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-568-7667
-----------------------------------------------------
Fax | 520-316-6677
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | TIM MCFARLAND
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 520-568-7667
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 7635
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------