Provider Demographics
NPI:1770274573
Name:BRECHEISEN, KATIE (DC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:BRECHEISEN
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 1:11333 N SCOTTSDALE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5190
Mailing Address - Country:US
Mailing Address - Phone:480-795-5329
Mailing Address - Fax:
Practice Address - Street 1:11333 N SCOTTSDALE RD STE 140
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5190
Practice Address - Country:US
Practice Address - Phone:480-795-5329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9225111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician