Provider Demographics
NPI:1992952626
Name:AXIS SOUTHWEST, LLC
Entity type:Organization
Organization Name:AXIS SOUTHWEST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WERNER
Authorized Official - Middle Name:
Authorized Official - Last Name:VON MARKSFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-889-1760
Mailing Address - Street 1:7330 E SHEA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6426
Mailing Address - Country:US
Mailing Address - Phone:480-889-1760
Mailing Address - Fax:480-889-1759
Practice Address - Street 1:7330 E SHEA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6426
Practice Address - Country:US
Practice Address - Phone:480-889-1760
Practice Address - Fax:480-889-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty