Provider Demographics
NPI:1326597626
Name:ACUCHIRO LLC
Entity Type:Organization
Organization Name:ACUCHIRO LLC
Other - Org Name:ACUCHIRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:SITHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:EDIRISOORIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-501-5136
Mailing Address - Street 1:2996 E MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-5724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2996 E MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-5724
Practice Address - Country:US
Practice Address - Phone:330-501-5136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8429111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ104194Medicare PIN