Provider Demographics
NPI:1073884219
Name:SHERRONA L. RAGO, DC, LLC
Entity Type:Organization
Organization Name:SHERRONA L. RAGO, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRONA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-314-4646
Mailing Address - Street 1:4930 E MAIN ST STE 13
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8006
Mailing Address - Country:US
Mailing Address - Phone:480-314-4646
Mailing Address - Fax:
Practice Address - Street 1:4930 E MAIN ST STE 13
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8006
Practice Address - Country:US
Practice Address - Phone:480-314-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1871651919OtherINDIVIDIUAL NPI