Provider Demographics
NPI:1710237284
Name:Q CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:Q CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:QUATI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKEETA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-808-8828
Mailing Address - Street 1:4105 N 20TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6027
Mailing Address - Country:US
Mailing Address - Phone:602-808-8828
Mailing Address - Fax:602-424-7866
Practice Address - Street 1:4105 N 20TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6027
Practice Address - Country:US
Practice Address - Phone:602-808-8828
Practice Address - Fax:602-424-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty