Provider Demographics
NPI:1316751274
Name:LOCAL CHIROPRACTIC STUDIO, LLC
Entity type:Organization
Organization Name:LOCAL CHIROPRACTIC STUDIO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DALESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-570-5423
Mailing Address - Street 1:8700 E VISTA BONITA DR STE 132
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4259
Mailing Address - Country:US
Mailing Address - Phone:480-944-2434
Mailing Address - Fax:630-388-0639
Practice Address - Street 1:8700 E VISTA BONITA DR STE 132
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4259
Practice Address - Country:US
Practice Address - Phone:480-944-2434
Practice Address - Fax:630-388-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty