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General NPI Number Information
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NPI Number | 1902004252
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Entity Type | Organization
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Legal Business Name | CARSON CHIROPRACTIC PC
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Dates
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Enumeration Date | 07/09/2007
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 7517 S MCCLINTOCK DR SUITE 104
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City | TEMPE
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State | AZ
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Zip | 85283-5011
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Country | US
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Telephone | 480-831-6050
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Fax | 480-940-3844
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Provider Business Mailing Address
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Address Line | 7517 S MCCLINTOCK DR SUITE 104
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City | TEMPE
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State | AZ
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Zip | 85283-5011
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Country | US
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Telephone | 480-831-6050
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Fax | 480-756-5707
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Authorized Official
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Title or Position | SEC/TREAS/VP
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Name | DR. RONDA L CARSON
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Credential | D.C.
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Telephone | 480-831-6050
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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 | 4492
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4493
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License Number State | AZ
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