Provider Demographics
NPI:1134470172
Name:FURRY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:FURRY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:FURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-458-1551
Mailing Address - Street 1:966 E FRY BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2640
Mailing Address - Country:US
Mailing Address - Phone:520-458-1551
Mailing Address - Fax:520-458-1896
Practice Address - Street 1:966 E FRY BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2640
Practice Address - Country:US
Practice Address - Phone:520-458-1551
Practice Address - Fax:520-458-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ24820Medicare PIN