Provider Demographics
NPI:1902051923
Name:FIRST CHOICE CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:FIRST CHOICE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-512-4040
Mailing Address - Street 1:7717 W DEER VALLEY RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2102
Mailing Address - Country:US
Mailing Address - Phone:623-512-4040
Mailing Address - Fax:623-512-4043
Practice Address - Street 1:7717 W DEER VALLEY RD
Practice Address - Street 2:SUITE 135
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2102
Practice Address - Country:US
Practice Address - Phone:623-512-4040
Practice Address - Fax:623-512-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64314Medicare UPIN