Provider Demographics
NPI:1326122334
Name:NEW BEGINNINGS CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NEW BEGINNINGS CHIROPRACTIC, INC.
Other - Org Name:NEW BEGINNINGS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DIONISIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-515-5432
Mailing Address - Street 1:21050 N TATUM BLVD
Mailing Address - Street 2:SUITE# 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4260
Mailing Address - Country:US
Mailing Address - Phone:480-515-5432
Mailing Address - Fax:480-515-5444
Practice Address - Street 1:21050 N TATUM BLVD
Practice Address - Street 2:SUITE# 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4260
Practice Address - Country:US
Practice Address - Phone:480-515-5432
Practice Address - Fax:480-515-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC4998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ85730Medicare ID - Type UnspecifiedMEDICARE GROUP