Provider Demographics
NPI:1134309867
Name:PORTERFIELD, NICHOLAS ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ADAM
Last Name:PORTERFIELD
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 1:375 E WARNER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1031
Mailing Address - Country:US
Mailing Address - Phone:602-663-5872
Mailing Address - Fax:480-505-1143
Practice Address - Street 1:375 E WARNER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1031
Practice Address - Country:US
Practice Address - Phone:602-663-5872
Practice Address - Fax:480-505-1143
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30747111N00000X
AZ8143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor