Provider Demographics
NPI:1386825594
Name:SUNCLOUD CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SUNCLOUD CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-458-1122
Mailing Address - Street 1:4032 LA LINDA WAY
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4602
Mailing Address - Country:US
Mailing Address - Phone:520-458-1122
Mailing Address - Fax:520-458-8628
Practice Address - Street 1:4032 LA LINDA WAY
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4602
Practice Address - Country:US
Practice Address - Phone:520-458-1122
Practice Address - Fax:520-458-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73144OtherPROVIDER NUMBER
AZU94064Medicare UPIN