Provider Demographics
NPI:1366409211
Name:ACORD, MICHAEL PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:ACORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 N 19TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7980
Mailing Address - Country:US
Mailing Address - Phone:602-864-0031
Mailing Address - Fax:602-864-0198
Practice Address - Street 1:7550 N 19TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7980
Practice Address - Country:US
Practice Address - Phone:602-864-0031
Practice Address - Fax:602-864-0198
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ28070750OtherWORKERS COMPENSATION