Provider Demographics
NPI:1104854520
Name:IACUONE, DAVID JAMES (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:IACUONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E THUNDERBIRD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5396
Mailing Address - Country:US
Mailing Address - Phone:602-439-1515
Mailing Address - Fax:602-439-1535
Practice Address - Street 1:720 E THUNDERBIRD RD STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5396
Practice Address - Country:US
Practice Address - Phone:602-439-1515
Practice Address - Fax:602-439-1535
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor