Organization
ALT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD A OGARA D,C (PRESIDENT)
(480) 833-7884
Entity
Organization
Contact information
Practice address
2210 W SOUTHERN AVE # B4, MESA, AZ 85202-4714
(480) 833-7884
Mailing address
2210 W SOUTHERN AVE # B4, MESA, AZ 85202-4714
(480) 833-7884
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
969
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0940640
BLUE CROSS PIN
AZ
Enumeration date
04/13/2007
Last updated
08/22/2020
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