1477615870 NPI number — BODYWORKS CHIROPRACTIC & WELLNESS CENTER INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477615870 NPI number — BODYWORKS CHIROPRACTIC & WELLNESS CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BODYWORKS CHIROPRACTIC & WELLNESS CENTER INC.
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:
1477615870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2705 S ALMA SCHOOL RD
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85286-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-802-1640
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2705 S ALMA SCHOOL ROAD #2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-802-1640
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STOWELL
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
GORDON
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
480-802-1640

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  6087 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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