| NPI | 1790729010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE BRADLEY KIMEL Vice Pres 602-993-1722 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AZ 5350) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 4269) |
| 111N00000X Chiropractor (Licence: AZ 7481) | |
| 111N00000X Chiropractor (Licence: AZ 7857) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-03-27 |