Provider Demographics
NPI:1528251527
Name:CHIRO CARE WELLNESS, INC
Entity type:Organization
Organization Name:CHIRO CARE WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-889-7398
Mailing Address - Street 1:7615 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-6083
Mailing Address - Country:US
Mailing Address - Phone:623-889-7398
Mailing Address - Fax:623-889-7411
Practice Address - Street 1:7615 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-6083
Practice Address - Country:US
Practice Address - Phone:623-889-7398
Practice Address - Fax:623-889-7411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU87233Medicare UPIN
AZ101144Medicare PIN