Provider Demographics
NPI:1588054290
Name:VERDE FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:VERDE FAMILY CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:JANA
Authorized Official - Last Name:KEHRLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-481-6796
Mailing Address - Street 1:6015 E LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2822 N 32ND ST
Practice Address - Street 2:STE 2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-1261
Practice Address - Country:US
Practice Address - Phone:818-481-6796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty