Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 17 Calle Baca, Tubac, Arizona |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215101506 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 7182 (Arizona) | Primary |
Mailing Address | Practice Location Address |
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Po Box 4197, Tubac, AZ 85646-4197 Ph: (520) 398-2773 | 17 Calle Baca, Tubac, AZ 85646 Ph: (520) 398-2773 |