Organization
PROFESSIONAL SPORTS CHIROPRACTIC LLC
Active
Other names
ProSports Integrative Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID FITZMAURICE D.C. (OWNER)
(520) 296-2515
Entity
Organization
Contact information
Practice address
310 N WILMOT RD, SUITE 103, TUCSON, AZ 85711-2618
(520) 296-2515
(520) 731-6597
Mailing address
310 N WILMOT RD, SUITE 103, TUCSON, AZ 85711-2618
(520) 296-2515
(520) 731-6597
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
7023
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093869646
NPI INDIVIDUAL
AZ
01
—
AZ0934970
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
03/20/2007
Last updated
08/22/2020
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