Provider Demographics
NPI:1356417182
Name:PASISIS, GEORGE T (DC CHIROPRACTOR)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:T
Last Name:PASISIS
Suffix:
Gender:M
Credentials:DC CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5714 E ANGELA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6409
Mailing Address - Country:US
Mailing Address - Phone:602-206-4438
Mailing Address - Fax:
Practice Address - Street 1:5714 E ANGELA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6409
Practice Address - Country:US
Practice Address - Phone:602-206-4438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0945560Medicare UPIN
AZZ105548Medicare ID - Type Unspecified