Provider Demographics
NPI:1750684080
Name:TUBA CITY CHIROPRACTIC AND ACUPUNCTURE
Entity Type:Organization
Organization Name:TUBA CITY CHIROPRACTIC AND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-283-5282
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-1550
Mailing Address - Country:US
Mailing Address - Phone:928-283-5282
Mailing Address - Fax:928-283-4134
Practice Address - Street 1:322 HIGHWAY 160
Practice Address - Street 2:SUITE 10
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-1550
Practice Address - Country:US
Practice Address - Phone:928-283-5282
Practice Address - Fax:928-283-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty