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NPI Code Detail

MEDICARE: DR. TRACEY REGAN D.C.

MEDICARE:  DR. TRACEY  REGAN  D.C.
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
1111N00000XChiropractor8100AZ

General Provider Information

NPI Number : 1689988321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACEY REGAN D.C.
Provider Business Mailing Address
First Line : 4910 E RAY RD
Second Line : #G9
City : PHOENIX
State : AZ
Zip : 85044-6419
Country : US
Telephone Number : 480-893-8000
Fax Number :
Provider Business Practice Location Address
First Line : 4910 E RAY RD
Second Line : #G9
City : PHOENIX
State : AZ
Zip : 85044-6419
Country : US
Telephone Number : 480-893-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2010
Last Update Date : 12/12/2011

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Directions to “ DR. TRACEY REGAN D.C.” Practice Location

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