Provider Demographics
NPI:1467782565
Name:VERANT CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:VERANT CHIROPRACTIC, INC.
Other - Org Name:VALENCIA CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:VERANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-294-2282
Mailing Address - Street 1:5433 S 12TH AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706-3386
Mailing Address - Country:US
Mailing Address - Phone:520-294-2282
Mailing Address - Fax:520-746-1465
Practice Address - Street 1:661 W VALENCIA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-7640
Practice Address - Country:US
Practice Address - Phone:520-294-2282
Practice Address - Fax:520-746-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty