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General NPI Number Information
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NPI Number | 1881733400
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Entity Type | Organization
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Legal Business Name | AGAPE ENTERPRISES, INC.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1513 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85015-6169
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Country | US
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Telephone | 602-266-5399
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Fax | 602-266-5759
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Provider Business Mailing Address
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Address Line | 1513 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85015-6169
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Country | US
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Telephone | 602-266-5399
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Fax | 602-266-5759
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIDGETT LOUISE JAMESON
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Credential | D.C
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Telephone | 602-266-5399
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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 | 6068
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License Number State | AZ
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