Organization
SPORT AND SPINE CHIROPRACTIC PLLC
Active
Other names
Axis Spine and Sport
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DYLAN HERNANDEZ DC (OWNER)
(702) 277-0578
Entity
Organization
Contact information
Practice address
2155 E UNIVERSITY DR STE 111, TEMPE, AZ 85281-4685
(480) 454-4776
Mailing address
2155 E UNIVERSITY DR STE 111, TEMPE, AZ 85281-4685
(480) 454-4776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548802333
NPI
AZ
Enumeration date
03/19/2020
Last updated
03/19/2020
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