Provider Demographics
NPI:1366637746
Name:PRESCOTT VALLEY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PRESCOTT VALLEY CHIROPRACTIC LLC
Other - Org Name:PRESCOTT VALLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHIFFERLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-775-0522
Mailing Address - Street 1:3088 N ROBERT RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-8429
Mailing Address - Country:US
Mailing Address - Phone:928-775-0522
Mailing Address - Fax:928-775-5922
Practice Address - Street 1:3088 N ROBERT RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8429
Practice Address - Country:US
Practice Address - Phone:928-775-0522
Practice Address - Fax:928-775-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ70964OtherPTAN
AZZ70964OtherPTAN