Provider Demographics
NPI: | 1609104587 |
---|---|
Name: | RITA RANCH CHIROPRACTIC & ACUPUNCTURE, INC |
Entity Type: | Organization |
Organization Name: | RITA RANCH CHIROPRACTIC & ACUPUNCTURE, INC |
Other - Org Name: | JAMES SUBA CHIROPRACTIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | DAVID |
Authorized Official - Last Name: | SUBA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 520-609-8900 |
Mailing Address - Street 1: | PO BOX 12190 |
Mailing Address - Street 2: | |
Mailing Address - City: | TUCSON |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85732-2190 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 520-609-8900 |
Mailing Address - Fax: | 520-293-1788 |
Practice Address - Street 1: | 698 E WETMORE RD |
Practice Address - Street 2: | STE 320 |
Practice Address - City: | TUCSON |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85705-1751 |
Practice Address - Country: | US |
Practice Address - Phone: | 520-408-2225 |
Practice Address - Fax: | 520-293-1788 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-12-03 |
Last Update Date: | 2009-12-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |