Provider Demographics
NPI:1669486908
Name:FORESIGHT CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:FORESIGHT CHIROPRACTIC PLC
Other - Org Name:FORESIGHT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:LAVENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-325-6977
Mailing Address - Street 1:2915 E BASELINE RD
Mailing Address - Street 2:SUITE 126
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2425
Mailing Address - Country:US
Mailing Address - Phone:480-325-6977
Mailing Address - Fax:602-296-0487
Practice Address - Street 1:2915 E BASELINE RD
Practice Address - Street 2:SUITE 126
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2425
Practice Address - Country:US
Practice Address - Phone:480-325-6977
Practice Address - Fax:602-296-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1346422086OtherDR. KEITH LAVENDER NPI #
AZ0945100OtherBLUE CROSS BLUE SHIELD
AZ1245414564OtherDR. WILLIAM JARMAN NPI #
AZ0932280OtherBLUE CROSS BLUE SHIELD
AZ1346422086OtherDR. KEITH LAVENDER NPI #
AZU77811Medicare UPIN
AZU82137Medicare UPIN
AZ1245414564OtherDR. WILLIAM JARMAN NPI #
AZ63089Medicare ID - Type UnspecifiedDR JARMAN