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General NPI Number Information
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NPI Number | 1871821298
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Entity Type | Organization
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Legal Business Name | POP'S CHIROPRACTIC, INC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 14940 W INDIAN SCHOOL RD SUITE 420
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City | GOODYEAR
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State | AZ
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Zip | 85395-7311
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Country | US
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Telephone | 623-935-1999
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Fax | 623-935-6601
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-0190
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Country | US
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Telephone | 623-935-1999
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Fax | 623-935-6601
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Authorized Official
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Title or Position | SECRETARY
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Name | CAROLYN ANN HUPPERT
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Credential |
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Telephone | 623-935-1999
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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 | 4819
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License Number State | AZ
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