Provider Demographics
NPI:1083648927
Name:PRISBREY, MICHAEL D (BS DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:PRISBREY
Suffix:
Gender:M
Credentials:BS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9221 E BASELINE RD
Mailing Address - Street 2:STE A109 #160
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8310
Mailing Address - Country:US
Mailing Address - Phone:480-969-4040
Mailing Address - Fax:480-833-9202
Practice Address - Street 1:4824 E BASELINE RD
Practice Address - Street 2:STE 140
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4676
Practice Address - Country:US
Practice Address - Phone:480-969-4040
Practice Address - Fax:480-830-9202
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ5970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor