Provider Demographics
NPI:1841914082
Name:PURE CHIROPRACTIC FAMILY LLC
Entity type:Organization
Organization Name:PURE CHIROPRACTIC FAMILY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-851-2178
Mailing Address - Street 1:201 W GUADALUPE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3327
Mailing Address - Country:US
Mailing Address - Phone:480-782-7705
Mailing Address - Fax:
Practice Address - Street 1:201 W GUADALUPE RD STE 201
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3327
Practice Address - Country:US
Practice Address - Phone:480-782-7705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty