Provider Demographics
NPI:1598295180
Name:WEATHERSBY CHIROPRACTIC
Entity Type:Organization
Organization Name:WEATHERSBY CHIROPRACTIC
Other - Org Name:ARIZONA CENTER FOR FAMILY AND WELLNESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEUEL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:WEATHERSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-978-3321
Mailing Address - Street 1:6033 W BELL RD STE H
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6033 W. BELL ROAD
Practice Address - Street 2:SUITE H
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3764
Practice Address - Country:US
Practice Address - Phone:602-978-3321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty