Provider Demographics
NPI:1871087023
Name:ADIO CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:ADIO CHIROPRACTIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-685-5006
Mailing Address - Street 1:562 HARMON LOOP RD STE NO129
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-6538
Mailing Address - Country:US
Mailing Address - Phone:671-637-8901
Mailing Address - Fax:671-637-8906
Practice Address - Street 1:562 HARMON LOOP RD STE NO129
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-6538
Practice Address - Country:US
Practice Address - Phone:671-637-8901
Practice Address - Fax:671-637-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUC31111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty