Individual
NICOLE RENEE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
15256 N 75TH AVE STE 360, PEORIA, AZ 85381-4761
(623) 486-2424
(623) 486-4324
Mailing address
1839 S ALMA SCHOOL RD STE 354, MESA, AZ 85210-3028
(480) 726-2287
(888) 316-9272
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2017015756
MO
111N00000X
Chiropractor
7855
CO
111N00000X
Chiropractor
Primary
8942
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017015756
MISSOURI STATE BOARD OF CHIROPRACTIC EXAMINERS
MO
Enumeration date
07/31/2017
Last updated
07/29/2020
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