Provider Demographics
NPI:1639551997
Name:CHANDLER MEDICAL PLLC
Entity Type:Organization
Organization Name:CHANDLER MEDICAL PLLC
Other - Org Name:BACKFIT HEALTH AND SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINOO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-926-7800
Mailing Address - Street 1:1450 W GUADALUPE RD
Mailing Address - Street 2:#120
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3042
Mailing Address - Country:US
Mailing Address - Phone:480-926-7800
Mailing Address - Fax:480-926-2260
Practice Address - Street 1:2824 E INDIAN SCHOOL RD
Practice Address - Street 2:#5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6863
Practice Address - Country:US
Practice Address - Phone:602-840-0056
Practice Address - Fax:480-926-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty