1144256611 NPI number — FIRST CHIROPRACTIC ALVERNON LLC

Table of content: MS. TASHA L. HANSEN MSW, LICSW (NPI 1457897498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144256611 NPI number — FIRST CHIROPRACTIC ALVERNON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST CHIROPRACTIC ALVERNON LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144256611
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1801 S ALVERNON WAY
Provider Second Line Business Mailing Address:
STE 107
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85711-6219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-790-1250
Provider Business Mailing Address Fax Number:
520-790-3477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 S ALVERNON WAY
Provider Second Line Business Practice Location Address:
STE 107
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85711-6219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-790-1250
Provider Business Practice Location Address Fax Number:
520-790-3477
Provider Enumeration Date:
06/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
O'NEAL
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
DONALD
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
520-886-4213

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com