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General NPI Number Information
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NPI Number | 1821517764
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Entity Type | Organization
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Legal Business Name | EMBARK CHIROPRACTIC WELLNESS PLLC
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 6424 E GREENWAY PARKWAY SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone | 650-557-0071
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Fax |
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Provider Business Mailing Address
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Address Line | 10645 N. TATUM BLVD, SUITE 200-668
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City | PHOENIX
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State | AZ
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Zip | 85028-3068
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Country | US
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Telephone | 650-557-0071
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Fax |
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | ALEXIS PARIAN
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Credential | D.C.
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Telephone | 650-557-0071
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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 | 8580
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License Number State | AZ
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