Provider Demographics
NPI:1639805385
Name:CHOTIPRADIT, MARALYS GABRIELA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARALYS
Middle Name:GABRIELA
Last Name:CHOTIPRADIT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6705 N BLACK CANYON HWY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1029
Mailing Address - Country:US
Mailing Address - Phone:480-442-4445
Mailing Address - Fax:480-907-1444
Practice Address - Street 1:6705 N BLACK CANYON HWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1029
Practice Address - Country:US
Practice Address - Phone:480-442-4445
Practice Address - Fax:480-907-1444
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty