# ASPEN RAE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659694156
- **Authorized official:** DR. SHANE ASPEN MCCALL D.C. (OWNER/ DOCTOR)
- **Authorized official phone:** (623) 572-9200

## Contact information

- **Practice address:** 21681 N 77TH AVE, SUITE 1415, PEORIA, AZ 85382-2132
- **Practice address phone:** (623) 572-9200
- **Practice address fax:** (623) 572-9204
- **Mailing address:** 21681 N 77TH AVE, SUITE 1415, PEORIA, AZ 85382-2132
- **Mailing address phone:** (623) 572-9200
- **Mailing address fax:** (623) 572-9204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | 7250 | AZ | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 2747 | AZ | — |

## Other

- **Enumeration date:** 03/11/2010
- **Last updated:** 02/02/2011