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General NPI Number Information
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NPI Number | 1952425589
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Entity Type | Organization
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Legal Business Name | LAKE PLEASANT CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9059 W LAKE PLEASANT PKWY SUITE 700
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City | PEORIA
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State | AZ
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Zip | 85382-8336
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Country | US
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Telephone | 623-572-4476
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Fax | 623-566-4918
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Provider Business Mailing Address
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Address Line | 9059 W LAKE PLEASANT PKWY SUITE 700
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City | PEORIA
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State | AZ
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Zip | 85382-8336
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Country | US
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Telephone | 623-572-4476
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Fax | 623-566-4918
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELANIE DIAS-ZAIR
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Credential | D.C.
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Telephone | 623-572-4476
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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 | 7439
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License Number State | AZ
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