Provider Demographics
NPI:1720025554
Name:ACTIVATOR HEALTH CENTER
Entity Type:Organization
Organization Name:ACTIVATOR HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-445-7575
Mailing Address - Street 1:2950 N 7TH ST
Mailing Address - Street 2:STE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5410
Mailing Address - Country:US
Mailing Address - Phone:602-445-7575
Mailing Address - Fax:602-604-7938
Practice Address - Street 1:2950 N 7TH ST
Practice Address - Street 2:STE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5410
Practice Address - Country:US
Practice Address - Phone:602-445-7575
Practice Address - Fax:602-604-7938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101677Medicare ID - Type UnspecifiedMEDICARE # FOR CLINIC