Provider Demographics
NPI:1922278506
Name:MICHAEL W ABROMOVITZ DC LLC
Entity Type:Organization
Organization Name:MICHAEL W ABROMOVITZ DC LLC
Other - Org Name:GILBERT CHIROPRACTIC AND ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WALDEN
Authorized Official - Last Name:ABROMOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-635-8228
Mailing Address - Street 1:1395 E WARNER RD
Mailing Address - Street 2:STE. C102
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3160
Mailing Address - Country:US
Mailing Address - Phone:480-635-8228
Mailing Address - Fax:480-635-9972
Practice Address - Street 1:1395 E WARNER RD
Practice Address - Street 2:STE. C102
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3160
Practice Address - Country:US
Practice Address - Phone:480-635-8228
Practice Address - Fax:480-635-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ135619Medicare UPIN