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General NPI Number Information
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NPI Number | 1790134724
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Entity Type | Organization
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Legal Business Name | HEALTHY BEGINNINGS FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 3303 S LINDSAY RD SUITE 125
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City | GILBERT
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State | AZ
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Zip | 85297-1503
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Country | US
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Telephone | 480-310-1792
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Fax |
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Provider Business Mailing Address
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Address Line | 3233 E RIDGEWOOD LN
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City | GILBERT
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State | AZ
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Zip | 85298-4305
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Country | US
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Telephone | 480-310-1792
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | JAMIE NICHOLE CLOUSE
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Credential | D.C.
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Telephone | 480-310-1792
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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 | 8400
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License Number State | AZ
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