Provider Demographics
NPI:1306005590
Name:A H CHIROPRACTIC & WELLNESS LLC.
Entity Type:Organization
Organization Name:A H CHIROPRACTIC & WELLNESS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HAINES
Authorized Official - Last Name:IVERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-990-9095
Mailing Address - Street 1:6360 E THOMAS RD STE 218
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7054
Mailing Address - Country:US
Mailing Address - Phone:480-990-9095
Mailing Address - Fax:480-941-1233
Practice Address - Street 1:6360 E THOMAS RD STE 218
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7054
Practice Address - Country:US
Practice Address - Phone:480-990-9095
Practice Address - Fax:480-941-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4858111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty