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Organization
WESTERN SPINAL CENTER PLLC
Active
Organization
WESTERN SPINAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM D SIPE DC (OWNER MEMBER)
(623) 334-9689
Entity
Organization
Contact information
Practice address
8751 N 51ST AVE, SUITE 124, GLENDALE, AZ 85302
(623) 334-9689
(623) 334-9687
Mailing address
8751 N 51ST AVE, SUITE 124, GLENDALE, AZ 85302-4945
(623) 334-9689
(623) 334-9687
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3483
AZ
225100000X
Physical Therapist
Primary
7011
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421610
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/13/2006
Last updated
11/06/2008
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