Provider Demographics
NPI:1801653472
Name:CHIROPRACTIC CONCIERGE OF AZ PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC CONCIERGE OF AZ PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-376-1359
Mailing Address - Street 1:7609 E PINNACLE PEAK RD STE C6
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3415
Mailing Address - Country:US
Mailing Address - Phone:203-376-1359
Mailing Address - Fax:
Practice Address - Street 1:7609 E PINNACLE PEAK RD STE C6
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3415
Practice Address - Country:US
Practice Address - Phone:203-376-1359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty