Provider Demographics
NPI:1750399291
Name:MAHER, JOSEPH L (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:MAHER
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 1:5115 N DYSART RD
Mailing Address - Street 2:STE 202 #611
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3036
Mailing Address - Country:US
Mailing Address - Phone:623-776-2225
Mailing Address - Fax:623-776-2299
Practice Address - Street 1:7710 W LOWER BUCKEYE RD
Practice Address - Street 2:STE 115
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-3439
Practice Address - Country:US
Practice Address - Phone:480-503-2400
Practice Address - Fax:480-539-4685
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU58228Medicare UPIN
AZ103667Medicare ID - Type Unspecified