Individual
VICENTE CHAVIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C, A.T.C.
Contact information
Practice address
10 E. RUTH AVE., PHOENIX, AZ 85020-3032
(480) 888-5555
Mailing address
1410 E. CHOLLA ST., PHOENIX, AZ 85020-1413
(480) 888-5555
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8328
AZ
2255A2300X
Athletic Trainer
ATR-001261
AZ
Other
Enumeration date
12/08/2011
Last updated
08/01/2019
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