Provider Demographics
NPI:1588745053
Name:GONSTEAD FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:GONSTEAD FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-815-1800
Mailing Address - Street 1:9420 W BELL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1362
Mailing Address - Country:US
Mailing Address - Phone:623-815-1800
Mailing Address - Fax:623-815-0500
Practice Address - Street 1:9420 W BELL RD STE 105
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1362
Practice Address - Country:US
Practice Address - Phone:623-815-1800
Practice Address - Fax:623-815-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7631111N00000X
AZ5857111N00000X
AZ5514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU73482Medicare UPIN
AZU62824Medicare UPIN
AZU41257Medicare UPIN