Provider Demographics
NPI:1245462738
Name:ARIZONA CHIROPRACTIC CLINIC, PLLC
Entity type:Organization
Organization Name:ARIZONA CHIROPRACTIC CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:520-219-5700
Mailing Address - Street 1:509 W WETMORE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1521
Mailing Address - Country:US
Mailing Address - Phone:520-219-5700
Mailing Address - Fax:520-219-5704
Practice Address - Street 1:509 W WETMORE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1521
Practice Address - Country:US
Practice Address - Phone:520-219-5700
Practice Address - Fax:520-219-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102582OtherMEDICARE PROVIDER NUMBER
AZP00667081OtherRAILROAD MEDICARE
AZV00868Medicare UPIN