Organization
MOHAVE CHIROPRACTIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALANA M JACKSON DC (SOLE MEMBER)
(928) 763-9225
Entity
Organization
Contact information
Practice address
1708 EL CAZADOR, BULLHEAD CITY, AZ 86442-7955
(928) 763-9225
(928) 763-9224
Mailing address
PO BOX 22698, BULLHEAD CITY, AZ 86439-2698
(928) 763-9225
(928) 763-9224
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7139
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
786080
—
AZ
01
—
P00100146
RAILROAD MEDICARE
AZ
01
—
P0155410
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
12/05/2006
Last updated
09/16/2008
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