Provider Demographics
NPI:1134276256
Name:PENTZ, DEBRA M (DC)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:M
Last Name:PENTZ
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 1:6402 E SUPERSTITION SPRINGS BLVD STE 123
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4391
Mailing Address - Country:US
Mailing Address - Phone:480-833-0302
Mailing Address - Fax:480-494-5770
Practice Address - Street 1:6402 E SUPERSTITION SPRINGS BLVD STE 123
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4391
Practice Address - Country:US
Practice Address - Phone:480-833-0302
Practice Address - Fax:480-494-5770
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6001111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5469728OtherCCN
AZAZ0248720OtherBCBS
AZ2150605Other1ST HEALTH
AZAZ0248720OtherBCBS
AZ5469728OtherCCN