Organization Name: | 1524 CORPORATION INC. |
NPI Number: | 1174793004 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSANA MARLENE PROBYN (PRESIDENT) |
Mailing Address: | 6047 E University Dr Mesa |
State: | AZ US |
Postal Code: | 852057517 |
Phone Number: | 4809853040 |
Fax Number: | 4809853040 |
NPI Enumeration Date: | 03/06/2008 |
NPI Last Update Date: | 10/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 5724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |