Provider Demographics
NPI:1528070331
Name:DUDLEY, JOSEPH PARKHILL (DC LAC)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PARKHILL
Last Name:DUDLEY
Suffix:
Gender:M
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 EAST BROADWAY
Mailing Address - Street 2:UNIT 1032
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-968-6205
Mailing Address - Fax:
Practice Address - Street 1:2334 NORTH SCOTTSDALE ROAD
Practice Address - Street 2:SUITE A 130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257
Practice Address - Country:US
Practice Address - Phone:480-440-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0632171100000X
AZ7927111N00000X
IAA31171100000X
NH004171100000X
MA365171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist