| Activate Chiropractic Clinic | |
|
3714 E Indian School Rd Ste 100 Phoenix AZ 85018-5107 | |
| (602) 224-0004 | |
| (602) 224-1182 |
| Full Name | Activate Chiropractic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3714 E Indian School Rd Ste 100, Phoenix, Arizona |
| Authorized Official Name and Position | Eric a Petermann (PRESIDENT) |
| Authorized Official Contact | 6022240004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Activate Chiropractic Clinic 3714 E Indian School Rd Ste 100 Phoenix AZ 85018-5107 Ph: (602) 224-0004 | Activate Chiropractic Clinic 3714 E Indian School Rd Ste 100 Phoenix AZ 85018-5107 Ph: (602) 224-0004 |
| NPI Number | 1871370536 |
|---|---|
| Provider Enumeration Date | 09/14/2023 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Medicare PECOS PAC ID | 3971967613 |
|---|---|
| Medicare Enrollment ID | O20230913001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871370536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Eric a Petermann |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1649241332 PECOS PAC ID: 2365423043 Enrollment ID: I20040527001153 |
Richard A. Snider, MD, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 |
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