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Individual

JOHN Q QUACKENBUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
42104 N VENTURE DRIVE, SUITE 101, ANTHEM, AZ 85086-3823
(623) 551-9100
(623) 551-9103
Mailing address
42104 N VENTURE DRIVE, SUITE 101, ANTHEM, AZ 85086-3823
(623) 551-9100
(623) 551-9103

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3034
CO
111N00000X
Chiropractor
Primary
7143
AZ

Other

Enumeration date
05/23/2006
Last updated
07/23/2009
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