Provider Demographics
NPI:1366596389
Name:GARRETT, JAMES P (DC MUAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:GARRETT
Suffix:
Gender:M
Credentials:DC MUAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 S MCCLINTOCK
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-730-9636
Mailing Address - Fax:480-730-0336
Practice Address - Street 1:3415 S MCCLINTOCK
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-730-9636
Practice Address - Fax:480-730-0336
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19361111N00000X
AZ4416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor