Provider Demographics
NPI:1740715218
Name:ZALLAHA, JAMES M (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:ZALLAHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 W GLENROSA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-2024
Mailing Address - Country:US
Mailing Address - Phone:480-284-2201
Mailing Address - Fax:
Practice Address - Street 1:4850 W GLENROSA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2024
Practice Address - Country:US
Practice Address - Phone:480-284-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4980111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor