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Individual

DR. PATRICIA LYNN PIVONKA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1355 S. HIGLEY ROAD STE 102, HIGLEY, AZ 85236-4705
(480) 892-0022
(480) 892-5509
Mailing address
1355 S. HIGLEY ROAD STE 102, HIGLEY, AZ 85236-4705
(480) 892-0022
(480) 892-5509

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3790
CO
111N00000X
Chiropractor
Primary
5505
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ 0242940
BLUECROSS BLUESHIELD AZ
AZ
Enumeration date
06/15/2006
Last updated
07/08/2007
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