Provider Demographics
NPI:1003946641
Name:STRAUB, CHERYLL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHERYLL
Middle Name:
Last Name:STRAUB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 E FORT LOWELL RD
Mailing Address - Street 2:STE. H
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1184
Mailing Address - Country:US
Mailing Address - Phone:520-327-4191
Mailing Address - Fax:520-327-4310
Practice Address - Street 1:4626 E FORT LOWELL RD
Practice Address - Street 2:STE. H
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1184
Practice Address - Country:US
Practice Address - Phone:520-327-4191
Practice Address - Fax:520-327-4310
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0116948038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ24418Medicare ID - Type Unspecified