Provider Demographics
NPI:1396744017
Name:ORMISTON, WILLIAM M (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:ORMISTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BILL
Other - Middle Name:M
Other - Last Name:ORMISTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2504 S RURAL RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2429
Mailing Address - Country:US
Mailing Address - Phone:480-968-7767
Mailing Address - Fax:480-968-0955
Practice Address - Street 1:2504 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2429
Practice Address - Country:US
Practice Address - Phone:480-968-7767
Practice Address - Fax:480-968-0955
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor