Provider Demographics
NPI:1871592212
Name:PRICE CHIROPRACTIC
Entity type:Organization
Organization Name:PRICE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-947-3979
Mailing Address - Street 1:7620 E INDIAN SCHOOL RD
Mailing Address - Street 2:#114
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3610
Mailing Address - Country:US
Mailing Address - Phone:480-947-3979
Mailing Address - Fax:480-941-2708
Practice Address - Street 1:7620 E INDIAN SCHOOL RD
Practice Address - Street 2:#114
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3610
Practice Address - Country:US
Practice Address - Phone:480-947-3979
Practice Address - Fax:480-941-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC5677Medicare ID - Type Unspecified
U65168Medicare UPIN