Provider Demographics
NPI:1366148496
Name:SPENCER FAMILY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:SPENCER FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-915-5855
Mailing Address - Street 1:2600 E SOUTHERN AVE STE K
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7743
Mailing Address - Country:US
Mailing Address - Phone:480-904-2583
Mailing Address - Fax:480-916-2017
Practice Address - Street 1:2600 E SOUTHERN AVE STE K
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7743
Practice Address - Country:US
Practice Address - Phone:480-904-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty