Agave Chiropractic, Llc | |
3040 N 44th St, Suite 3, Phoenix, AZ 85018-7225 | |
(602) 956-8736 | |
(602) 956-8769 |
Full Name | Agave Chiropractic, Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 3040 N 44th St, Phoenix, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982046975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 5355 (Arizona) | Primary |
Provider Name | Paul W Van Berkel |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1902824311 PECOS PAC ID: 8325066327 Enrollment ID: I20051108000910 |
Mailing Address | Practice Location Address |
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Agave Chiropractic, Llc 3040 N 44th St, Suite 3, Phoenix, AZ 85018-7225 Ph: (602) 956-8736 | Agave Chiropractic, Llc 3040 N 44th St, Suite 3, Phoenix, AZ 85018-7225 Ph: (602) 956-8736 |
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