Provider Demographics
NPI:1235316258
Name:JEFFREY A. RAIFFIE, D.C., PLLC
Entity Type:Organization
Organization Name:JEFFREY A. RAIFFIE, D.C., PLLC
Other - Org Name:RAIFFIE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:RAIFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-222-5500
Mailing Address - Street 1:6929 N HAYDEN RD
Mailing Address - Street 2:SUITE C7
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7978
Mailing Address - Country:US
Mailing Address - Phone:480-222-5500
Mailing Address - Fax:480-222-5501
Practice Address - Street 1:6929 N HAYDEN RD
Practice Address - Street 2:SUITE C7
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7978
Practice Address - Country:US
Practice Address - Phone:480-222-5500
Practice Address - Fax:480-222-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ72079Medicare UPIN