Provider Demographics
NPI:1619003233
Name:WARMAN, ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WARMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 N MAGDALENA ST
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-7220
Mailing Address - Country:US
Mailing Address - Phone:928-445-4059
Mailing Address - Fax:928-445-4319
Practice Address - Street 1:8113 E FLORENTINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8461
Practice Address - Country:US
Practice Address - Phone:928-445-4059
Practice Address - Fax:928-445-4319
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0930190OtherBLUE CROSS
AZZ61745Medicare ID - Type UnspecifiedMEDICARE