Provider Demographics
NPI:1992989842
Name:REACH CHIROPRACTIC
Entity type:Organization
Organization Name:REACH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:REACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-867-4210
Mailing Address - Street 1:12802 N CAVE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-5825
Mailing Address - Country:US
Mailing Address - Phone:602-867-4210
Mailing Address - Fax:602-867-7600
Practice Address - Street 1:12802 N CAVE CREEK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5825
Practice Address - Country:US
Practice Address - Phone:602-867-4210
Practice Address - Fax:602-867-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT88249Medicare UPIN
AZZ76670Medicare PIN