Provider Demographics
NPI:1235420340
Name:AQUA CHIROPRACTIC & DAY SPA PLLC
Entity Type:Organization
Organization Name:AQUA CHIROPRACTIC & DAY SPA PLLC
Other - Org Name:AQUA CHIROPRACTIC & DAY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZEYAD
Authorized Official - Middle Name:DANNY
Authorized Official - Last Name:ABOUL-HOSN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-887-1327
Mailing Address - Street 1:3970 W 24TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-9255
Mailing Address - Country:US
Mailing Address - Phone:928-782-1818
Mailing Address - Fax:888-899-2073
Practice Address - Street 1:3970 W 24TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-9255
Practice Address - Country:US
Practice Address - Phone:928-782-1818
Practice Address - Fax:888-899-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8168111N00000X
171100000X, 173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty