Provider Demographics
NPI:1780867614
Name:HOOD CHIROPRACTIC FAMILY WELLNESS, INC
Entity Type:Organization
Organization Name:HOOD CHIROPRACTIC FAMILY WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-610-4663
Mailing Address - Street 1:1925 E BROWN RD
Mailing Address - Street 2:SUITE A1
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-5135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1925 E BROWN RD
Practice Address - Street 2:SUITE A1
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5135
Practice Address - Country:US
Practice Address - Phone:480-610-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0944290OtherBLUE CROSS BLUE SHIELD
AZ0944290OtherBLUE CROSS BLUE SHIELD