Provider Demographics
NPI:1831371541
Name:ADULT & CHILDRENS CHIROPRACTIX, PC
Entity type:Organization
Organization Name:ADULT & CHILDRENS CHIROPRACTIX, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREIHEIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-345-7650
Mailing Address - Street 1:6625 S RURAL RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3717
Mailing Address - Country:US
Mailing Address - Phone:480-345-7650
Mailing Address - Fax:480-491-3037
Practice Address - Street 1:6625 S RURAL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3717
Practice Address - Country:US
Practice Address - Phone:480-345-7650
Practice Address - Fax:480-491-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ20051Medicare UPIN