Provider Demographics
NPI:1366695413
Name:NOVAK, RACHEL JOY (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:JOY
Last Name:NOVAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 N WILMOT RD STE 3A
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-8000
Mailing Address - Country:US
Mailing Address - Phone:520-390-2966
Mailing Address - Fax:
Practice Address - Street 1:1951 N WILMOT RD STE 3A
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-8000
Practice Address - Country:US
Practice Address - Phone:520-390-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-01
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7977111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor