Organization
COLLISION CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L WAGONER (MANAGER)
(480) 343-0585
Entity
Organization
Contact information
Practice address
11 W VAN BUREN ST, AVONDALE, AZ 85323-1313
(480) 343-0585
Mailing address
16356 N THOMPSON PEAK PKWY APT 1089, SCOTTSDALE, AZ 85260-2103
(480) 343-0585
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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