Provider Demographics
NPI:1427049840
Name:NEMANIC, PETER M (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:NEMANIC
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 E RAY RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6419
Mailing Address - Country:US
Mailing Address - Phone:480-785-7246
Mailing Address - Fax:480-753-5252
Practice Address - Street 1:4910 E RAY RD
Practice Address - Street 2:SUITE 9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6419
Practice Address - Country:US
Practice Address - Phone:480-785-7246
Practice Address - Fax:480-753-5252
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9573111N00000X
AZ7947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor