Provider Demographics
NPI:1609249739
Name:DUFOUR ACCIDENT CHIROPRACTIC & ACUPUNCTURE CENTER
Entity Type:Organization
Organization Name:DUFOUR ACCIDENT CHIROPRACTIC & ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUFOUR
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC, FIAMA
Authorized Official - Phone:480-839-2225
Mailing Address - Street 1:1467 W ELLIOT RD
Mailing Address - Street 2:STE 103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5167
Mailing Address - Country:US
Mailing Address - Phone:480-839-2225
Mailing Address - Fax:480-755-4703
Practice Address - Street 1:1467 W ELLIOT RD
Practice Address - Street 2:STE 103
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5167
Practice Address - Country:US
Practice Address - Phone:480-839-2225
Practice Address - Fax:480-755-4703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUFOUR ACCIDENT CHIROPRACTIC & ACUPUNCTURE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty