Provider Demographics
NPI:1174873376
Name:GARCIA, MARIA ROSARIO (DC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSARIO
Last Name:GARCIA
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:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-1016
Mailing Address - Country:US
Mailing Address - Phone:520-648-5859
Mailing Address - Fax:520-648-3255
Practice Address - Street 1:75 W CALLE DE LAS TIENDAS
Practice Address - Street 2:SUITE 121B
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4235
Practice Address - Country:US
Practice Address - Phone:520-648-5859
Practice Address - Fax:520-648-3255
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor