Provider Demographics
NPI:1356401368
Name:MUSCLE RESTORATION AND CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:MUSCLE RESTORATION AND CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:PHATUROS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-717-7465
Mailing Address - Street 1:4432 E DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2362
Mailing Address - Country:US
Mailing Address - Phone:602-717-7465
Mailing Address - Fax:
Practice Address - Street 1:10613 N HAYDEN RD STE J107
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5576
Practice Address - Country:US
Practice Address - Phone:602-717-7465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty