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OUTBACK CHIROPRACTIC LLC NPI 1811175482


NPI Information

NPI: 1811175482
Provider Name: OUTBACK CHIROPRACTIC LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1200 W. CLEVELAND
SAINT JOHNS, AZ
ZIP 85936
Phone: (928) 337-3125
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OUTBACK CHIROPRACTIC LLC is a chiropractor in Saint Johns, AZ. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. OUTBACK CHIROPRACTIC LLC NPI is 1811175482. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 W. CLEVELAND
SAINT JOHNS, AZ
ZIP 85936-200
Phone: (928) 337-3125
Fax: (928) 337-3291

The provider's authorized official is Lanny Craig Crockett .
The authorized official title is Owner/president and has the following contact phone number (928) 337-3125.

The enumeration date for this NPI number is 2/6/2008 and was last updated on 2/6/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1U98718MEDICARE UPINARIZONA
2841595MEDICAIDARIZONA
3Z78280MEDICARE PINARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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