Provider Demographics
NPI:1215729892
Name:CENTRIC CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:CENTRIC CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-904-2513
Mailing Address - Street 1:2083 W SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6779
Mailing Address - Country:US
Mailing Address - Phone:602-904-2513
Mailing Address - Fax:
Practice Address - Street 1:3303 S LINDSAY RD STE 119A
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2100
Practice Address - Country:US
Practice Address - Phone:602-904-2513
Practice Address - Fax:480-605-3728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty