Provider Demographics
NPI:1295059889
Name:FAMILY HEALTH PC
Entity type:Organization
Organization Name:FAMILY HEALTH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-565-7076
Mailing Address - Street 1:2354 S CORDES RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86413-8774
Mailing Address - Country:US
Mailing Address - Phone:928-565-7976
Mailing Address - Fax:938-565-7176
Practice Address - Street 1:1734 HIGHWAY 95 STE 102
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-6999
Practice Address - Country:US
Practice Address - Phone:928-234-2264
Practice Address - Fax:928-565-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty