Provider Demographics
NPI:1528252368
Name:INLINE FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:INLINE FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-566-7976
Mailing Address - Street 1:15282 W BROOKSIDE LN
Mailing Address - Street 2:STE. 118
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2447
Mailing Address - Country:US
Mailing Address - Phone:623-566-7976
Mailing Address - Fax:623-584-4388
Practice Address - Street 1:15282 W BROOKSIDE LN
Practice Address - Street 2:STE. 118
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2447
Practice Address - Country:US
Practice Address - Phone:623-566-7976
Practice Address - Fax:623-584-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7556111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty