Provider Demographics
NPI:1376728675
Name:DARRE HOLDINGS LTD
Entity Type:Organization
Organization Name:DARRE HOLDINGS LTD
Other - Org Name:DC CANYON HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-215-4107
Mailing Address - Street 1:15027 W BELL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3216
Mailing Address - Country:US
Mailing Address - Phone:623-215-4107
Mailing Address - Fax:623-215-7453
Practice Address - Street 1:15027 W BELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3216
Practice Address - Country:US
Practice Address - Phone:623-215-4107
Practice Address - Fax:623-215-7453
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DARRE HOLDINGS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7436111N00000X
AZ0468171100000X
AZ07-992175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV06523Medicare UPIN
AZZ105446Medicare PIN