MEDICARE: A1 HEALTH AND WELLNESS

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	5096	AZ

General Provider Information

NPI Number	:	1568668556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1 HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	PO BOX 1287
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85139-0380
Country	:	US
Telephone Number	:	520-494-7788
Fax Number	:	520-494-7789

Provider Business Practice Location Address
First Line	:	44302 W MARICOPA CASA GRANDE HWY
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85138-2942
Country	:	US
Telephone Number	:	520-494-7788
Fax Number	:	520-494-7789

Authorized Official
Title or Position	:	OWNER CHIROPRACTOR
Name	:	JOHN DONOHUE
Credential	:	DC
Telephone Number	:	520-494-7788

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	02/20/2013

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Practice Location Address:

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Directions to “A1 HEALTH AND WELLNESS ” Practice Location

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