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General NPI Number Information
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NPI Number | 1639495435
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Entity Type | Organization
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Legal Business Name | NR CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 4900 N LITCHFIELD ROAD BYP
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5061
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Country | US
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Telephone | 623-512-8568
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Fax |
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Provider Business Mailing Address
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Address Line | 13841 W KEIM DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5343
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Country | US
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Telephone | 623-512-8568
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | NEIL RAYMOND
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Credential | DC
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Telephone | 623-512-8568
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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 | 7422
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License Number State | AZ
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