Provider Demographics
NPI:1902193824
Name:B N CHIRO
Entity Type:Organization
Organization Name:B N CHIRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-206-8786
Mailing Address - Street 1:23425 N 39TH DR
Mailing Address - Street 2:STE 103
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-4199
Mailing Address - Country:US
Mailing Address - Phone:623-433-8185
Mailing Address - Fax:623-433-8434
Practice Address - Street 1:23425 N 39TH DR
Practice Address - Street 2:STE 103
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-4199
Practice Address - Country:US
Practice Address - Phone:623-433-8185
Practice Address - Fax:623-433-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC7308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty