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Organization

MOUNTAIN CHIROPRACTIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL S. FLAKE DC, CCSP (PRESIDENT)
(928) 474-8417
Entity
Organization

Contact information

Practice address
411 S BEELINE HWY, SUITE C, PAYSON, AZ 85541-4892
(928) 474-8417
(928) 474-8417
Mailing address
411 S BEELINE HWY, SUITE C, PAYSON, AZ 85541-4892
(928) 474-8417
(928) 474-8417

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC3716
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120589
PTAN
AZ
Enumeration date
02/05/2008
Last updated
03/27/2008
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