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General NPI Number Information
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NPI Number | 1962183343
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Entity Type | Organization
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Legal Business Name | M&M PREMIER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 6955 E BASELINE RD SUITE 103
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City | MESA
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State | AZ
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Zip | 85209-4808
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Country | US
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Telephone | 480-524-2318
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 E BASELINE RD SUITE 103
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City | MESA
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State | AZ
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Zip | 85209-4808
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Country | US
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Telephone | 480-524-2318
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. MISTIE AHRENS
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Credential | DC
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Telephone | 480-524-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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