Provider Demographics
NPI:1679637649
Name:GUY G HUSTON, D.C.
Entity Type:Organization
Organization Name:GUY G HUSTON, D.C.
Other - Org Name:ARROWHEAD WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-776-9300
Mailing Address - Street 1:18001 N 79TH AVE
Mailing Address - Street 2:SUITE B 20
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8388
Mailing Address - Country:US
Mailing Address - Phone:623-776-9300
Mailing Address - Fax:623-776-9210
Practice Address - Street 1:18001 N 79TH AVE
Practice Address - Street 2:SUITE B 20
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8388
Practice Address - Country:US
Practice Address - Phone:623-776-9300
Practice Address - Fax:623-776-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ105451Medicare PIN
AZZ105453Medicare PIN
AZZ105452Medicare PIN