Provider Demographics
NPI:1376017202
Name:KOEHLER, TONY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:JAMES
Last Name:KOEHLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14891 N NORTHSIGHT BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2635
Mailing Address - Country:US
Mailing Address - Phone:480-408-8684
Mailing Address - Fax:480-999-5561
Practice Address - Street 1:14891 N NORTHSIGHT BLVD STE 117
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2635
Practice Address - Country:US
Practice Address - Phone:480-408-8684
Practice Address - Fax:480-999-5561
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty