Organization
5TH STREET ASSOCIATES, INC
Active
Other names
associates in chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH DIANE KELEHER-DICKERSON (OWNER/BOOKKEEPER)
(520) 745-1611
Entity
Organization
Contact information
Practice address
6145 E 5TH ST, TUCSON, AZ 85711-2505
(520) 745-1611
(520) 745-7846
Mailing address
6145 E 5TH ST, TUCSON, AZ 85711-2505
(520) 745-1611
(520) 745-7846
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
0078522
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3746055
ACN GROUP
AZ
01
—
AZ0234480
BLUE CROSS
AZ
01
—
WC28100310
WORKERS COMPENSATION
AZ
Enumeration date
11/03/2006
Last updated
08/22/2020
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