Provider Demographics
NPI:1255423505
Name:DIANA, CARLA ELAINE (DC)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ELAINE
Last Name:DIANA
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 1:3431 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-5641
Mailing Address - Country:US
Mailing Address - Phone:602-548-1998
Mailing Address - Fax:602-547-1480
Practice Address - Street 1:3431 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-5641
Practice Address - Country:US
Practice Address - Phone:602-548-1998
Practice Address - Fax:602-547-1480
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor