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General NPI Number Information
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NPI Number | 1992170674
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Entity Type | Organization
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Legal Business Name | DOVE MOUNTAIN CHIROPRACTIC AND MASSAGE LLC
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 12040 N THORNYDALE RD STE 102
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City | MARANA
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State | AZ
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Zip | 85658-4721
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Country | US
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Telephone | 248-930-1599
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Fax |
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Provider Business Mailing Address
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Address Line | 12040 N THORNYDALE RD STE 102
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City | MARANA
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State | AZ
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Zip | 85658-4721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/OWNER
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Name | DR. BRIAN JAMES SCHNURR JR.
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Credential | D.C.
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Telephone | 248-930-1599
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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 | 8500
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License Number State | AZ
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