Provider Demographics
NPI:1093948390
Name:CHRISTINA M KESZLER
Entity Type:Organization
Organization Name:CHRISTINA M KESZLER
Other - Org Name:SYNERGY WELLNESS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:KESZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-951-4825
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85547-0207
Mailing Address - Country:US
Mailing Address - Phone:928-951-4825
Mailing Address - Fax:
Practice Address - Street 1:6420 E BROADWAY BLVD
Practice Address - Street 2:SUITE B102-D
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3536
Practice Address - Country:US
Practice Address - Phone:928-951-4825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77670Medicare PIN