Provider Demographics
NPI:1104022813
Name:MICHAEL DAVIS DC LLC
Entity Type:Organization
Organization Name:MICHAEL DAVIS DC LLC
Other - Org Name:CHIROPRACTIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-535-8661
Mailing Address - Street 1:1616 N LITCHFIELD RD STE 250
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-1298
Mailing Address - Country:US
Mailing Address - Phone:623-535-8661
Mailing Address - Fax:623-535-8662
Practice Address - Street 1:1616 N LITCHFIELD RD STE 250
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1298
Practice Address - Country:US
Practice Address - Phone:623-535-8661
Practice Address - Fax:623-535-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty