Provider Demographics
NPI:1255691689
Name:ACHIEVING BALANCE CHIROPRACTIC & WELLNESS, PLLC.
Entity Type:Organization
Organization Name:ACHIEVING BALANCE CHIROPRACTIC & WELLNESS, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:LYTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-578-9886
Mailing Address - Street 1:8060 E GELDING DR STE 104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6960
Mailing Address - Country:US
Mailing Address - Phone:602-678-9886
Mailing Address - Fax:
Practice Address - Street 1:8060 E GELDING DR STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6960
Practice Address - Country:US
Practice Address - Phone:602-678-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty