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General NPI Number Information
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NPI Number | 1972841252
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Entity Type | Organization
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Legal Business Name | LLACA CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 7555 E OSBORN RD STE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6434
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Country | US
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Telephone | 480-652-4788
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Fax | 480-945-7805
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Provider Business Mailing Address
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Address Line | 7555 E OSBORN RD STE 102
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6434
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Country | US
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Telephone | 480-652-4788
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Fax | 480-945-7805
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. REBECCA LLACA
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Credential | D.C.
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Telephone | 480-652-4788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 8126
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License Number State | AZ
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