Provider Demographics
NPI:1457865420
Name:NBC OPERATIONS-PHOENIX, LLC
Entity Type:Organization
Organization Name:NBC OPERATIONS-PHOENIX, LLC
Other - Org Name:NECK AND BACK CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KESTNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CFO
Authorized Official - Phone:702-644-3333
Mailing Address - Street 1:8678 SPRING MOUNTAIN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4103
Mailing Address - Country:US
Mailing Address - Phone:702-644-3333
Mailing Address - Fax:702-644-3336
Practice Address - Street 1:6750 W THUNDERBIRD RD STE B-101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5026
Practice Address - Country:US
Practice Address - Phone:602-368-1333
Practice Address - Fax:602-368-9373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NBC OPERATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty