Provider Demographics
NPI:1578613758
Name:WESTOWN CHIROPRACTIC
Entity Type:Organization
Organization Name:WESTOWN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEFKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-993-6340
Mailing Address - Street 1:12414 N 28TH DR STE D
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2488
Mailing Address - Country:US
Mailing Address - Phone:602-993-6340
Mailing Address - Fax:602-993-1070
Practice Address - Street 1:12414 N 28TH DR STE D
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2488
Practice Address - Country:US
Practice Address - Phone:602-993-6340
Practice Address - Fax:602-993-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0083270OtherBCBS PROVIDER ID
AZ480603855Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID