| Crotalus Chiropractic Centers, Plc | |
|
3540 E Baseline Rd Ste 117, Phoenix, AZ 85042-9628 | |
| (602) 777-7970 | |
| (877) 771-6086 |
| Full Name | Crotalus Chiropractic Centers, Plc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 3540 E Baseline Rd Ste 117, 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 |
|---|---|---|---|
| 1073001590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 6095 (Arizona) | Primary |
| Provider Name | Brendan P O'connor |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154538700 PECOS PAC ID: 1052555455 Enrollment ID: I20130925000776 |
| Mailing Address | Practice Location Address |
|---|---|
| Crotalus Chiropractic Centers, Plc 3540 E Baseline Rd Ste 117, Phoenix, AZ 85042-9628 Ph: (602) 777-7970 | Crotalus Chiropractic Centers, Plc 3540 E Baseline Rd Ste 117, Phoenix, AZ 85042-9628 Ph: (602) 777-7970 |
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