Provider Demographics
NPI:1497865661
Name:DEVORE MEEHAN, CATHERINE A (DC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:DEVORE MEEHAN
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 1:8426 W PEORIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345
Mailing Address - Country:US
Mailing Address - Phone:623-979-3998
Mailing Address - Fax:623-878-5976
Practice Address - Street 1:8426 W PEORIA AVE STE B
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345
Practice Address - Country:US
Practice Address - Phone:623-979-3998
Practice Address - Fax:623-878-5976
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0942420OtherBC BS
AZ189159000OtherUS DEPT OF LABOR
AZ2141842OtherAETNA
AZ1011517OtherAMERICAN SPECIALTY HEALTH
AZ44-00092OtherUNITED HEALTHCARE
AZ0030682OtherHEALTHNET
AZ20110OtherAMERICAN WHOLE HEALTH
AZ7642480OtherGHI
AZP00189172OtherRR MEDICARE
AZ20110OtherAMERICAN WHOLE HEALTH
AZ7642480OtherGHI