Provider Demographics
NPI:1437223492
Name:AXIS CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:AXIS CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELTRAMINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-404-8735
Mailing Address - Street 1:13636 N TATUM BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-404-8735
Mailing Address - Fax:602-404-8736
Practice Address - Street 1:13636 N TATUM BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-404-8735
Practice Address - Fax:602-404-8736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5637111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU64250Medicare UPIN
AZZ122552Medicare UPIN