Provider Demographics
NPI:1215407911
Name:PRITCHARD, DAVID JON (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JON
Last Name:PRITCHARD
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 1:24250 N 23RD AVE UNIT 3171
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-1989
Mailing Address - Country:US
Mailing Address - Phone:616-403-0387
Mailing Address - Fax:
Practice Address - Street 1:1614 W WHISPERING WIND DR STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0809
Practice Address - Country:US
Practice Address - Phone:602-345-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8767111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician