Provider Demographics
NPI:1528370657
Name:NORTH MESA CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NORTH MESA CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:SCHUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-969-2425
Mailing Address - Street 1:1925 E BROWN RD STE A1
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-5135
Mailing Address - Country:US
Mailing Address - Phone:480-969-2425
Mailing Address - Fax:480-969-5524
Practice Address - Street 1:1925 E BROWN RD STE A1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5135
Practice Address - Country:US
Practice Address - Phone:480-969-2425
Practice Address - Fax:480-969-5524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3410R111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty