Provider Demographics
NPI:1982336541
Name:SUN CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:SUN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GOULOOZE
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:602-618-0444
Mailing Address - Street 1:13925 W MEEKER BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4431
Mailing Address - Country:US
Mailing Address - Phone:623-584-2328
Mailing Address - Fax:623-584-4796
Practice Address - Street 1:13925 W MEEKER BLVD STE 7
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4431
Practice Address - Country:US
Practice Address - Phone:623-584-2328
Practice Address - Fax:623-584-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty