Provider Demographics
NPI:1700460482
Name:REGENT HEALTHCARE AT DC RANCH
Entity Type:Organization
Organization Name:REGENT HEALTHCARE AT DC RANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-234-9436
Mailing Address - Street 1:3847 E EXPEDITION WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-5483
Mailing Address - Country:US
Mailing Address - Phone:480-234-9436
Mailing Address - Fax:
Practice Address - Street 1:18501 N THOMPSON PEAK PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6087
Practice Address - Country:US
Practice Address - Phone:480-515-4053
Practice Address - Fax:480-304-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty