MEDICARE: PIMA CHIROPRACTIC INC

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	5831	AZ

General Provider Information

NPI Number	:	1538265376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIMA CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	5806 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5611
Country	:	US
Telephone Number	:	520-722-1585
Fax Number	:	520-866-3452

Provider Business Practice Location Address
First Line	:	5806 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5611
Country	:	US
Telephone Number	:	520-722-1585
Fax Number	:	520-866-3452

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. KURT H WILSON
Credential	:
Telephone Number	:	520-722-1585

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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