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General NPI Number Information
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NPI Number | 1982889473
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Entity Type | Organization
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Legal Business Name | SCP CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 4767 N 20TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-4706
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Country | US
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Telephone | 602-631-4500
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Fax | 602-631-4427
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Provider Business Mailing Address
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Address Line | 4767 N 20TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-4706
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Country | US
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Telephone | 602-631-4500
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Fax | 602-631-4427
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA HAGGARD
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Credential | DC
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Telephone | 602-631-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 5638
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License Number State | AZ
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