Provider Demographics
NPI:1164443321
Name:MESA CHIROPRACTIC AND REHABILITATION CENTER P C
Entity Type:Organization
Organization Name:MESA CHIROPRACTIC AND REHABILITATION CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHAER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-826-2277
Mailing Address - Street 1:623 N PARSELL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-7235
Mailing Address - Country:US
Mailing Address - Phone:602-826-2277
Mailing Address - Fax:
Practice Address - Street 1:613 S MESA DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-2543
Practice Address - Country:US
Practice Address - Phone:480-644-1227
Practice Address - Fax:480-644-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4050111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ111032Medicare PIN
AZDC4050Medicare UPIN