MEDICARE: DR. CLIFTON GUY MACK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	6098	AZ
2	225100000X	Physical Therapist	3683	AZ

General Provider Information

NPI Number	:	1225193147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFTON GUY MACK DC

Provider Business Mailing Address
First Line	:	5761 E BROWN RD
Second Line	:	SUITE 23
City	:	MESA
State	:	AZ
Zip	:	85205-4449
Country	:	US
Telephone Number	:	480-641-8352
Fax Number	:	480-641-0541

Provider Business Practice Location Address
First Line	:	5761 E BROWN RD
Second Line	:	SUITE 23
City	:	MESA
State	:	AZ
Zip	:	85205-4449
Country	:	US
Telephone Number	:	480-641-8352
Fax Number	:	480-641-0541

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	01/18/2026

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Directions to “ DR. CLIFTON GUY MACK DC” Practice Location

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