Provider Demographics
NPI:1437811924
Name:NEUFANG CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NEUFANG CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NEUFANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-893-2400
Mailing Address - Street 1:11011 SOUTH 48TH STREET
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1787
Mailing Address - Country:US
Mailing Address - Phone:480-893-2400
Mailing Address - Fax:480-553-9545
Practice Address - Street 1:11011 SOUTH 48TH STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-1787
Practice Address - Country:US
Practice Address - Phone:480-893-2400
Practice Address - Fax:480-553-9545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty