Provider Demographics
NPI:1033638978
Name:AZ CHIRO & ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:AZ CHIRO & ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-568-5437
Mailing Address - Street 1:PO BOX 1307
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-0380
Mailing Address - Country:US
Mailing Address - Phone:520-568-5437
Mailing Address - Fax:520-568-8575
Practice Address - Street 1:44400 W HONEYCUTT RD STE 101
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2945
Practice Address - Country:US
Practice Address - Phone:520-568-5437
Practice Address - Fax:520-568-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty