Provider Demographics
NPI:1356563555
Name:PARADISE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:PARADISE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-703-2399
Mailing Address - Street 1:7450 E PINNACLE PEAK RD STE 154
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3605
Mailing Address - Country:US
Mailing Address - Phone:480-419-8900
Mailing Address - Fax:480-419-9212
Practice Address - Street 1:7450 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 154
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3435
Practice Address - Country:US
Practice Address - Phone:480-419-8900
Practice Address - Fax:480-419-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty