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Organization

CADILLAC CHIROPRACTIC,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD WADE RANDALL D.C. (CHIROPRACTOR)
(602) 863-2277
Entity
Organization

Contact information

Practice address
1736 W BELL RD, PHOENIX, AZ 85023-3414
(602) 863-2277
(602) 866-7475
Mailing address
1736 W BELL RD, PHOENIX, AZ 85023-3414
(602) 863-2277
(602) 866-7475

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4147
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111N00000X
TAXONOMY
AZ
Enumeration date
08/10/2012
Last updated
08/10/2012
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