Organization
ARIZONA SPORTS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYSON WADE MAROSTICA D.C. (CHIROPRACTOR)
(610) 906-6164
Entity
Organization
Contact information
Practice address
5735 E MCKELLIPS RD, SUITE B-106, MESA, AZ 85215-2875
(602) 668-8109
Mailing address
5735 E MCKELLIPS RD, SUITE B-106, MESA, AZ 85215-2875
(602) 668-8109
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
AZ
Other
Enumeration date
02/01/2016
Last updated
08/01/2016
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