Provider Demographics
NPI:1407984933
Name:NEY, PETER (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:NEY
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 1:1785 W HIGHWAY 89A
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5567
Mailing Address - Country:US
Mailing Address - Phone:928-282-7575
Mailing Address - Fax:
Practice Address - Street 1:1785 W STATE ROUTE 89A
Practice Address - Street 2:SUITE 3C
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5567
Practice Address - Country:US
Practice Address - Phone:928-282-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC5154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ64608Medicare PIN