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General NPI Number Information
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NPI Number | 1851537559
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Entity Type | Organization
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Legal Business Name | ANCALA CHIROPRACTIC INC
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 11259 E VIA LINDA STE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4076
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Country | US
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Telephone | 480-661-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 11259 E VIA LINDA STE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4076
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Country | US
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Telephone | 480-661-6449
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MITCHELL BORST
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Credential | D.C.
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Telephone | 480-661-6449
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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 | 5301
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License Number State | AZ
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