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General NPI Number Information
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NPI Number | 1902193824
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Entity Type | Organization
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Legal Business Name | B N CHIRO
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 23425 N 39TH DR STE 103
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City | GLENDALE
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State | AZ
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Zip | 85310-4199
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Country | US
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Telephone | 623-433-8185
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Fax | 623-433-8434
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Provider Business Mailing Address
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Address Line | 23425 N 39TH DR STE 103
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City | GLENDALE
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State | AZ
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Zip | 85310-4199
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Country | US
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Telephone | 623-433-8185
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Fax | 623-433-8434
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENNY NIXON
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Credential | D.C.
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Telephone | 480-206-8786
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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 | DC7308
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License Number State | AZ
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