Organization
VICENA CHIROPRACTIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIANNE ELIZABETH REMALIA (OFFICE MANAGER)
(480) 854-2222
Entity
Organization
Contact information
Practice address
6344 E BROADWAY RD, SUITE 102, MESA, AZ 85206-1634
(480) 854-2222
(480) 807-3781
Mailing address
6344 E BROADWAY RD, SUITE 102, MESA, AZ 85206-1634
(480) 854-2222
(480) 807-3781
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5429
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z4184
HEALTHNET
AZ
01
—
AZ0247740
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
04/24/2007
Last updated
08/22/2020
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