Provider Demographics
NPI:1356541411
Name:ESSENTIAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ESSENTIAL CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HRUBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-941-2147
Mailing Address - Street 1:5410 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE D100
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5927
Mailing Address - Country:US
Mailing Address - Phone:480-941-2147
Mailing Address - Fax:480-941-2157
Practice Address - Street 1:5410 N SCOTTSDALE RD
Practice Address - Street 2:SUITE D100
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-5927
Practice Address - Country:US
Practice Address - Phone:480-941-2147
Practice Address - Fax:480-941-2157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8005111N00000X
AZ4118225100000X
AZ3780225100000X
AZ#MT-03907P225700000X
AZ7432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty