Provider Demographics
NPI:1568490126
Name:BOUKUS INC
Entity Type:Organization
Organization Name:BOUKUS INC
Other - Org Name:ARCADIA HEALTH AND WELLNESS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-954-9444
Mailing Address - Street 1:3520 E INDIAN SCHOOL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5156
Mailing Address - Country:US
Mailing Address - Phone:602-954-9444
Mailing Address - Fax:
Practice Address - Street 1:3520 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5156
Practice Address - Country:US
Practice Address - Phone:602-954-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ110439Medicare ID - Type Unspecified