Provider Demographics
NPI:1467479113
Name:MONEYHAN, CHRISTINA M (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:MONEYHAN
Suffix:
Gender:F
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:PO BOX 2718
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85217-2718
Mailing Address - Country:US
Mailing Address - Phone:480-830-7300
Mailing Address - Fax:480-654-6557
Practice Address - Street 1:7205 E SOUTHERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2790
Practice Address - Country:US
Practice Address - Phone:480-830-7300
Practice Address - Fax:480-654-6557
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ-008507OtherBLUE CROSS BLUE SHIELD
AZZ$$$$$$$$$Medicare PIN