Provider Demographics
NPI:1669402897
Name:RAYMOND, NEIL (D C)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13841 W KEIM DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5343
Mailing Address - Country:US
Mailing Address - Phone:623-512-8568
Mailing Address - Fax:
Practice Address - Street 1:4900 N LITCHFIELD ROAD BYP
Practice Address - Street 2:SUITE C-2
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-5061
Practice Address - Country:US
Practice Address - Phone:623-512-8568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ83074Medicare PIN
AZV00901Medicare UPIN