Provider Demographics
NPI:1952585291
Name:ABDALLAH, ADHAM HANNA (DC)
Entity Type:Individual
Prefix:DR
First Name:ADHAM
Middle Name:HANNA
Last Name:ABDALLAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 S MILTON RD
Mailing Address - Street 2:STE 14
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-6336
Mailing Address - Country:US
Mailing Address - Phone:602-993-0131
Mailing Address - Fax:602-993-7335
Practice Address - Street 1:1855 W GREENWAY RD
Practice Address - Street 2:SUITE 111
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-3475
Practice Address - Country:US
Practice Address - Phone:602-993-0131
Practice Address - Fax:602-993-7335
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ7884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor