Organization
KINGSWOOD PARKE FAMILY CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WESLEY ENOUEN D.C. (CHIROPRACTOR)
(623) 556-4772
Entity
Organization
Contact information
Practice address
15508 W BELL RD STE 105, SURPRISE, AZ 85374-2432
(623) 556-4772
(623) 556-2316
Mailing address
15508 W BELL RD STE 105, SURPRISE, AZ 85374-2432
(623) 556-4772
(623) 556-2316
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5489
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0241860
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
04/24/2007
Last updated
08/30/2012
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