Provider Demographics
NPI:1255771366
Name:CHIROPRACTIC DEL SOL LLC
Entity type:Organization
Organization Name:CHIROPRACTIC DEL SOL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-334-1064
Mailing Address - Street 1:1619 E MCDOWELL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-3098
Mailing Address - Country:US
Mailing Address - Phone:602-334-1064
Mailing Address - Fax:602-354-3655
Practice Address - Street 1:1619 E MCDOWELL RD
Practice Address - Street 2:SUITE C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3098
Practice Address - Country:US
Practice Address - Phone:602-334-1064
Practice Address - Fax:602-354-3655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty