MEDICARE: ARIZONA HEALTH CARE CLINIC PC

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	111NR0400X	Rehabilitation Chiropractor	3386	AZ
2	111N00000X	Chiropractor	5571	AZ

General Provider Information

NPI Number	:	1568681104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA HEALTH CARE CLINIC PC

Provider Business Mailing Address
First Line	:	33755 N SCOTTSDALE RD
Second Line	:	SUITE 101
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-1567
Country	:	US
Telephone Number	:	480-595-6100
Fax Number	:	480-595-6102

Provider Business Practice Location Address
First Line	:	33755 N SCOTTSDALE RD
Second Line	:	SUITE 101
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-1567
Country	:	US
Telephone Number	:	480-595-6100
Fax Number	:	480-595-6102

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JON M TANNER
Credential	:	D.C
Telephone Number	:	480-595-6100

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	11/15/2007

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Directions to “ARIZONA HEALTH CARE CLINIC PC ” Practice Location

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