Provider Demographics
NPI:1396380960
Name:DUXBURY, KIRK (DC)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:DUXBURY
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 1:85 W COMBS RD STE 109
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-9107
Mailing Address - Country:US
Mailing Address - Phone:480-822-9105
Mailing Address - Fax:480-458-5833
Practice Address - Street 1:85 W COMBS RD STE 109
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-9107
Practice Address - Country:US
Practice Address - Phone:480-882-9105
Practice Address - Fax:480-458-5833
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor