Provider Demographics
NPI:1336322106
Name:AVONDALE CHIROPRACTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:AVONDALE CHIROPRACTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOLLIHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-535-8984
Mailing Address - Street 1:13050 W RANCHO SANTA FE BLVD
Mailing Address - Street 2:SUITE B-5
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-1756
Mailing Address - Country:US
Mailing Address - Phone:623-535-8984
Mailing Address - Fax:
Practice Address - Street 1:13050 W RANCHO SANTA FE BLVD
Practice Address - Street 2:SUITE B-5
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1756
Practice Address - Country:US
Practice Address - Phone:623-535-8984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty