Provider Demographics
NPI:1760695043
Name:SALBERG FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:SALBERG FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-445-2004
Mailing Address - Street 1:202 N GRANITE ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3026
Mailing Address - Country:US
Mailing Address - Phone:928-445-2004
Mailing Address - Fax:
Practice Address - Street 1:202 N GRANITE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3026
Practice Address - Country:US
Practice Address - Phone:928-445-2004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5956111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73443Medicare ID - Type Unspecified
AZU75525Medicare UPIN