Provider Demographics
NPI:1821204835
Name:RUMMAGE, ALLENE D (DC)
Entity Type:Individual
Prefix:
First Name:ALLENE
Middle Name:D
Last Name:RUMMAGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N 1ST AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-1902
Mailing Address - Country:US
Mailing Address - Phone:602-358-7429
Mailing Address - Fax:602-358-7434
Practice Address - Street 1:101 N 1ST AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1902
Practice Address - Country:US
Practice Address - Phone:602-358-7429
Practice Address - Fax:602-358-7434
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0944000Medicare UPIN