Provider Demographics
NPI:1710166962
Name:CHIROHEALTH LLC
Entity Type:Organization
Organization Name:CHIROHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEPHI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-876-5500
Mailing Address - Street 1:PO BOX 10956
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85230-0956
Mailing Address - Country:US
Mailing Address - Phone:520-876-5500
Mailing Address - Fax:480-393-4613
Practice Address - Street 1:511 E FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-4113
Practice Address - Country:US
Practice Address - Phone:520-876-5500
Practice Address - Fax:480-393-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ108946Medicare PIN