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Organization
ASPEN RAE LLC
Active
Organization
ASPEN RAE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE ASPEN MCCALL D.C. (OWNER/ DOCTOR)
(623) 572-9200
Entity
Organization
Contact information
Practice address
21681 N 77TH AVE, SUITE 1415, PEORIA, AZ 85382-2132
(623) 572-9200
(623) 572-9204
Mailing address
21681 N 77TH AVE, SUITE 1415, PEORIA, AZ 85382-2132
(623) 572-9200
(623) 572-9204
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
7250
AZ
207QA0000X
Adolescent Medicine (Family Medicine) Physician
2747
AZ
Other
Enumeration date
03/11/2010
Last updated
02/02/2011
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