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Organization

CHIROPRACTIC FITNESS CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOUGLAS BIRT CHANDLER D.C. (OWNER, CHIROPRACTOR)
(928) 778-6200
Entity
Organization

Contact information

Practice address
809 GAIL GARDNER WAY STE B, PRESCOTT, AZ 86305-1801
(928) 778-6200
(928) 778-9034
Mailing address
9870 S 46TH ST, PHOENIX, AZ 85044-5533
(928) 778-6200
(928) 778-9034

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7082
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0938370
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
10/13/2006
Last updated
08/22/2020
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