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General NPI Number Information
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NPI Number | 1720108087
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Entity Type | Individual
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Provider Name | SUE ANN WAHLERS D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13811 N 35TH DR STE D
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City | PHOENIX
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State | AZ
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Zip | 85053-5524
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Country | US
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Telephone | 602-993-2009
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Fax | 602-993-2028
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Provider Business Mailing Address
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Address Line | 3327 W MOUNTAIN VIEW RD
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City | PHOENIX
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State | AZ
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Zip | 85051-1243
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Country | US
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Telephone | 602-375-0331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4480
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License Number State | AZ
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